Hyponatremia in heart failure: how common is it, clinical significance and methods of correction
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Abstract
Hyponatremia is an electrolyte disturbance defined as a decrease in serum sodium concentration of less than 135 mmol/L and is the most common electrolyte abnormality in hospitalized patients. The reported incidence of hyponatremia varies by healthcare facility, clinical setting, and the definition of hyponatremia used, but can be as high as 30% of patients in some studies. The prevalence of hyponatremia is increasing, according to studies. According to the duration, hyponatremia is classified as acute (up to 48 hours) and chronic (more than 48 hours). The severity of the sodium ion level is classified as: severe – serum sodium level is < 125 mmol/L; moderate – serum sodium level is 125–129 mmol/L; mild – the serum sodium level is 130–134 mmol/L. Acute heart failure (AHF) is a common condition that often leads to hospitalization. Treatment should be aimed at the underlying cause of HF and adequate elimination of congestion. For this purpose, loop diuretics are preferred, which have potential side effects, including hyponatremia. Therapeutic approaches to correcting hyponatremia can be different, using specific and non-specific drugs, with the addition of either diuretics or additional fluids, but the main thing is to diagnose this electrolyte disorder in a timely manner and to normalize the sodium levels in the blood of patients quickly enough. The rate of normalization of sodium levels should not be too slow, but not too fast either, as this leads to complications. Hyponatremia in patients with heart failure is a very serious complication, but timely correction of sodium deficiency prevents adverse effects.
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