TABLE 3

Causes of hyponatremia and their usual corresponding urine studies and urine output

Volume statusEtiologyUrine osmolalityUrine sodiumADH-dependentUrine output
HypovolemicVolume loss (nonrenal)> 100 mOsm/Kg< 30 mmol/LYesDecreased
Cerebral salt wasting> 100 mOsm/Kg> 30 mmol/LYesIncreased
Diuretics> 100 mOsm/Kg> 30 mmol/LYesIncreased
EuvolemicSyndrome of inappropriate ADH> 100 mOsm/Kg> 30 mmol/LYesDecreased
Low-solute state< 100 mOsm/Kga< 30 mmol/LNoVariable
Primary polydipsia< 100 mOsm/KgVariableNoIncreased
Reset osmostatVariableVariableNoVariable
HypervolemicCirrhosis> 100 mOsm/Kg< 30 mmol/LYesDecreased
Heart failure> 100 mOsm/Kg< 30 mmol/LYesDecreased
Kidney failure> 100 mOsm/Kg> 30 mmol/LNoDecreased
  • a The osmolality in a low-solute state can be higher in a concomitant hypovolemic state.

  • ADH = antidiuretic hormone