How is the hyponatremia management in hospitalized patients? A cross-sectional study

Abstract Background: Hyponatremia is the most frequent hydroelectrolytic disorder in hospitalized patients and is associated with mortality. A lack in the diagnostic and therapeutic management of the hyponatremic hospitalized patient has been reported. Hyponatremia in hospitalized patients is usually managed by specialties other than nephrology and endocrinology. The aim of our study is to describe the diagnostic and therapeutic management of hyponatremia by clinicians from services other than endocrinology and nephrology in hospitalized patients.Methods: Cross-sectional, descriptive study of a consecutive case series of adult patients hospitalized with hyponatremia, in a tertiary hospital of Madrid, during January 1st-May 30th 2019, handled by non-endocrinologist nor nephrologist clinicians. We analyzed data regarding the details of the diagnostic assessment and the treatment established by the clinicians of the respective hospitalization service. Results: 32 cases studied, all of them with hypovolemic hyponatremia, 50% women, 50% managed in the emergency room. Volemic classification of hyponatremia was described in only 18.8%. The height of the internal jugular venous pulse was not measured in any case. Urine studies were developed in below 70% of cases. 50% of patients had a congruent treatment with the previous described volemic status. Only one case had a complete and successful diagnostic and therapeutic approach in accordance to clinical guidelines.Conclusion: In our series there was a lack in the diagnostic and therapeutic management of hyponatremia of hospitalized patients by non-endocrinologists and non-nephrologists.