Hyponatremia primary prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Saeedeh Kowsarnia M.D.[2]

In patients at risk of developing hyponatremia, preventing approaches has to be done to eliminate aggravation of hyponatremia.

• Hypotonic fluids and thiazide diuretics should be avoided, especially in patients at increased risk for hyponatremia.
• Avoid polypharmacy in elderly, espceially thiazide diuretics and anti-depressants. ^[1]
• Use isotonic fluids (like 5% dextrose in a solution of 0.9% saline in patients with well controlled congestive heart failure) instead of the common clinical practice of hypotonic fluids as maintenance therapy in elderly hospitalized patients. ^[1]
• Thiazides should be avoided in persons with high fluid or low protein intake and during acute illness.
• Monitor body weight for runners and encourage to drink water when they are thirsty, and prevent overdrinking during exercise. ^[2]
• Patients with history of anti-depressant induced hyponatremia may be prescribed bupropion instead of more commonly used drugs. ^[1]
• Early sodium supplementation of enteral feedings in very premature infants averts hyponatremia and enhances weight gain. ^[3]

To see the risk factors associated with hyponatremia, click here.

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