| Written by Dr.Md.Redwanul Huq (Masum) |
| Tuesday, 22 January 2013 04:31 |
Causes of Hypernatraemia:
1. Inadequate water retention (i.e. excessive water loss) by kidney:
i) Diabetes insipidus
ii) Diabetic ketoacidosis
iii) Hyperosmolar non- ketotic diabetic coma
2. Excessive Na+ retention :
i) Hyper-aldosteronism
ii) Cushing Syndrome
3. Excessive Na+ intake:
i) Diet
ii) Hypertonic sodium solution
4. Increased loss of water through lungs and skin:
i) Fever
ii) Hyperventilation
iii) Hot environment
iv) Hypothyroidism
5. Inadequate water intake.
Causes of hyponatraemia:
A. Hyponatraemia associated with decreased extracellular fluid(ECF) volume
(i.e.depletional hyponatraemia):
1. Gastrointestinal tract (GIT) loss:
i) Diarrhea
ii) Vomiting
iii) Sequestration of fluid in bowel as in intestinal obstruction or paralytic ileus
iv) Fistula
2. Renal loss:
i) Addison’s disease
ii) Chronic renal failure,
iii) Salt losing nephropathy
iv) Use of excessive diuretics (e.g. osmotic diuretics)
v) Chronic interstitial nephritis
vi) Polycystic kidney disease
3. Cutaneous loss-
i) Severe burn
ii) Excessive sweating
4. Inadequate intake of salt due to environmental deprivation or inadequate therapeutic replacement
5.Metabolic acidosis.
B. Hyponatraemia associated with normal or slightly increased ECF volume:
1. Syndrome of inappropriate ADH secretion (SIADH) due to-
i) Bronchogenic carcinoma
ii) Carcinoma pancreas
iii) Dudenal carcinoma
iv) Cerebrovascular accident
v) Bronchietasis
vi) Pneumonia
2. Excessive intravenous fluid
3. Hypothyroidism
4. Psychogenic polydypsia.
C. Hyponatraemia associated with increased ECF volume: (i.e. dilutional hyponatraemia):
1. Cirrhosis of liver
2. Congestive cardiac failure
3. Nephrotic syndrome.
Causes of Metabolic acidosis:
Causes of Metabolic acidosis are as following-
1. Accumulation of excessive acids in plasma:
i) Lactic acidosis
ii) Ketoacidosis (e.g. Diabetic ketoacidosis)
iii) Salicylate poisoning
iv) Methanol poisoning
2. Decreased excretion of acids from plasma:
i) Acute renal failure
ii) Chronic renal failure
iii) Distal renal tubular acidosis
3. Bicarbonate loss:
i) Diarrhoea
ii) Uretero-sigmoidostomy
iii) Intestinal fistula.
