Mathias Jay, Lovekar Shachi, Yap Jayson
Internal Medicine, Wright State University, Dayton, USA.
Nephrology, Dayton Veterans Affairs (VA) Medical Center, Dayton, USA.
Cureus. 2024 Aug 14;16(8):e66833. doi: 10.7759/cureus.66833. eCollection 2024 Aug.
Hyponatremia is defined as serum sodium less than 135 mEq/L and is principally a result of water excess relative to total body sodium content. The evaluation of hyponatremia is incomplete without a careful assessment of the patient's volume status, history, and acquisition of both serum and urine osmolality and sodium studies. Many of these studies can be affected by various clinical factors, and these nuances should be considered while interpreting the results. This is because these results guide the etiologic diagnosis of hyponatremia and consequently its management. In this report, we describe a 50-year-old male being evaluated for hyponatremia found to have unusual serum/urine osmolality studies but ultimately found to have an unmeasured serum osmole (ethanol) interfering with the interpretation of these results. Clinical scenarios that interfere with serum and urine studies commonly obtained in a hyponatremia evaluation are reviewed and an equation to correct for ethanol's osmotic contribution is described.
低钠血症定义为血清钠低于135 mEq/L，主要是相对于总体钠含量而言水过多所致。如果不仔细评估患者的容量状态、病史以及获取血清和尿渗透压及钠的检查结果，对低钠血症的评估就是不完整的。许多这些检查结果可能会受到各种临床因素的影响，在解释结果时应考虑这些细微差别。这是因为这些结果指导低钠血症的病因诊断以及后续治疗。在本报告中，我们描述了一名50岁男性因低钠血症接受评估，发现其血清/尿渗透压检查结果异常，但最终发现有一种未测血清渗透质（乙醇）干扰了这些结果的解读。本文回顾了在低钠血症评估中常见的干扰血清和尿液检查的临床情况，并描述了一个校正乙醇渗透贡献的公式。
