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A Journal on Endocrine System Diseases

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Minerva Endocrinologica 2014 March;39(1):1-12

language: English

Drug-induced hyponatremia: an updated review

Ramos-Levi A. M. 1, Duran Rodriguez-Hervada A. 2, Mendez-Bailon M. 3, Marco-Martinez J. 3

1 Department of Endocrinology and Nutrition Princesa University Hospital IIS Princesa, Madrid, Spain;
2 Department of Endocrinology and Nutrition San Carlos Clinical Hospital IdISSC, Madrid, Spain;
3 Department of Internal Medicine San Carlos Clinical Hospital IdISSC, Madrid, Spain


Hyponatremia, defined as serum sodium concentrations <135 mmol/L, is the most frequent electrolyte disturbance observed in both hospitalized and ambulatory patients, and has been associated to relevant negative consequences regarding morbidity and mortality. Drug-induced hyponatremia has been widely observed. However, since it may be clinically symptomatic or asymptomatic, it is frequently an underdiagnosed condition. This review aims to highlight the main drugs involved in the pathophysiology of hyponatremia, which should be considered in the differential diagnosis when approaching a patient with hyponatremia. We discuss their impact and relative importance. In order to prevent undesirable negative consequences we also emphasize the need for awareness of this clinically-relevant adverse effect, and we suggest how clinical management of patients may be approached.

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