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Review
. 2020 Jul 23;17(15):5320.
doi: 10.3390/ijerph17155320.

Hyponatremia in Infectious Diseases-A Literature Review

Anna L Królicka  1 , Adrianna Kruczkowska  1 , Magdalena Krajewska  2 , Mariusz A Kusztal  2
Affiliations
Review

Hyponatremia in Infectious Diseases-A Literature Review

Anna L Królicka et al. Int J Environ Res Public Health. .

Abstract

Hyponatremia is one of the most common water-electrolyte imbalances in the human organism. A serum sodium concentration threshold of less than 135 mmol/L is diagnostic for hyponatremia. The disorder is usually secondary to various diseases, including infections. Our review aims to summarize the diagnostic value and impact of hyponatremia on the prognosis, length of the hospitalization, and mortality among patients with active infection. The scientific literature regarding hyponatremia was reviewed using PubMed, ClinicalKey, and Web of Science databases. Studies published between 2011 and 2020 were screened and eligible studies were selected according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and specific inclusion criteria. The most common infections that were associated with hyponatremia were viral and bacterial infections, including COVID-19 (coronavirus disease 2019). The etiology varied according to the infection site, setting and patient cohort it concerned. In several studies, hyponatremia was associated with prolonged hospitalization, worse outcomes, and higher mortality rates. Hyponatremia can also play a diagnostic role in differentiating pathogens that cause a certain infection type, as it was observed in community-acquired pneumonia. Although many mechanisms leading to hyponatremia have already been described, it is impossible with any certainty to ascribe the etiology of hyponatremia to any of them.

Keywords: hyponatremia; infections; infectious diseases; syndrome of inappropriate antidiuretic hormone secretion.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Types of hyponatremia.
Figure 2
Figure 2
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 flow diagram.
See this image and copyright information in PMC

References

    1. Rondon-Berrios H., Agaba E.I., Tzamaloukas A.H. Hyponatremia: Pathophysiology, classification, manifestations and management. Int. Urol. Nephrol. 2014;46:2153–2165. doi: 10.1007/s11255-014-0839-2. - DOI - PubMed
    1. Upadhyay A., Jaber B.L., Madias N.E. Incidence and Prevalence of Hyponatremia. Am. J. Med. 2006;119:S30–S35. doi: 10.1016/j.amjmed.2006.05.005. - DOI - PubMed
    1. Mohan S., Gu S., Parikh A., Radhakrishnan J. Prevalence of Hyponatremia and Association with Mortality: Results from NHANES. Am. J. Med. 2013;126:1127–1137. doi: 10.1016/j.amjmed.2013.07.021. - DOI - PMC - PubMed
    1. Corona G., Giuliani C., Parenti G., Norello D., Verbalis J.G., Forti G., Maggi M., Peri A. Moderate Hyponatremia Is Associated with Increased Risk of Mortality: Evidence from a Meta-Analysis. PLoS ONE. 2013;8:e80451. doi: 10.1371/journal.pone.0080451. - DOI - PMC - PubMed
    1. Winzeler B., Jeanloz N., Nigro N., Suter-Widmer I., Schuetz P., Arici B., Bally M., Blum C., Bock A., Huber A., et al. Long-term outcome of profound hyponatremia: A prospective 12 months follow-up study. Eur. J. Endocrinol. 2016;175:499–507. doi: 10.1530/EJE-16-0500. - DOI - PubMed

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