Compre o eBook Interpretação Clínica do Metabolismo Hidroeletrolítico e do equilíbrio hidroeletrolítico, ou seja, da água, dos sais e do distúrbio ácido-básico. Hiponatremia é o distúrbio hidroeletrolítico mais comum em pacientes hospitalizados. A presença de hiponatremia está associada a uma série de desfechos. dissociação proteino-citológica relativa (6) e séptica (4), hipoglicorraquia moderada (4%), hipoglicorraquia severa (4%), distúrbio hidroeletrolítico (3%).

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Evaluation of the patient with hyponatremia. Central venous pressure as a guide to volume expansi- on.

Am J Med ; Etiology and diagnostic investigation When faced with a hyponatremic patient, the first step should be to rule out pseudohyponatremia. We also found correlation with pleocytosis and lymphocytosis Table 2. Rev Med Chil ; Alterations of consciousness are commom in patients with tuberculous meningo-encephalitis TMEregardless of HIV-positivity 2. Another strategy is the administration of a mL bolus over 10 minutes of hypertonic saline for patients with symptomatic hyponatremia.

The presence of a natriuretic factor in uri- ne of patients with chronic uremia. Etiological diagnosis Whenever possible, it is important to remove the cause by: Only the results of the first CSF analysis were included. The correlation between the Pandy and Nonne reactions and the lumbar puncture might depend upon the greater protein concentration in this region. Dilutional hyponatremia during endoscopic curettage: Effects of an arterio- venous fistula on renal disyurbio and electrolyte excretion.

Nephrogenic syndrome of inappropriate antidiuresis. Impact of hospital-associated hyponatremia on selected outcomes. History and physical examination suggest an edematous syndrome, such as CHF, cirrhosis or nephrotic syndrome. There was little correlation between the clinical data and the CSF syndromes.


One may notice that even in hypovolemic hyponatremia there is a relative excess of water in relation to total sodium. Hyponatremia in psychogenic polydipsia. Water excess results in dilution of serum sodium and hyponatremia. Waiting for more specific manifestations may delay the hisroeletrolitico of treatable diseases, like bacterial or fungal meningitis.

The high urinary osmolality suggests the presence of ADH.

Riella Disturbios Hidroeletroliticos – Capítulo do livro de Nefrologia de Riella

The correlation of the Pandy, Nonne and Weichbrodt reactions with the positivity of hematoxo might be due to the presence of the antibodies against toxoplasma. However, in AIDS patients, the viral syndrome may reflect a variety of infections commonly found in HIV-positive patients, mainly toxoplasmosis, as is shown in the correlation of the viral syndrome and the positivity of Hematoxo.

Economic impact of hyponatremia in hospitalized patients: Mortality after hospitalization with mild, moderate, and severe hyponatremia. Frequently, the diagnosis defies clinicians and becomes much based upon laboratorial tests, like neuroradiological methods and a CSF analysis.

IV solutions and IV orders. Since after 48 hours of hyponatremia the aforementioned adaptive mechanisms are already in place, it is wise to treat most cases slowly. Findings in Healthy, Asymptomatic, Seropositive Men.

Atualidades em Nefrologia, Eds: But why don’t the kidneys of hyponatremic patients excrete the water excess? Well conducted prospective studies in CHF patients showed that correction of hyponatremia with Tolvaptan, a V2 disturhio antagonist, did not reduce hospital admissions for heart failure nor mortality rates due to cardiovascular diseases or other causes.

Cerebrospinal fluid syndromes in HIV-positive patients with acute consciousness compromise

However, in practice, the administration of normal saline does not usually disturblo serum sodium in patients with SIADH; it may actually worsen hyponatremia Box 3. Postgrad Med ; The correlation of an altered macroscopic aspect of the CSF and neurocryptococosis, of septic syndrome and a diagnosis of a syndrome considered sufficient is interesting. Since neurological hidroeletrolltico resulting from pontine myelinolysis is frequently irreversible, the best alternative is prevention.


An illustrative clinical scenario would be that of an individual who spends the day drinking beer. Euvolemia There should be an absence of history and physical examination data suggesting hypo or hypervolemia. Pseudohyponatremia with high serum osmolality.


Even without the serum osmolality of the patient, it is possible to rule out pseudohyponatremia due to the severity of serum sodium reduction and by the normal results of blood glucose, lipid profile, total proteins and fractions. These situations do not represent disorders of water metabolism and therapeutic measures should not be aimed at correcting the serum sodium concentration.

She denied using diuretics or other medications. The most common cause of hypertonic hyponatremia is hyperglycemia, but it can also occur during the administration of hyperosmolar ionic contrast.

Hidroeletroliitico Neuropsiquiatr ; Given the high frequency of antibodies against Toxoplama gondii in asymptomatic HIV-positive patients, this might be interpreted with caution 9. The commonest clinical data were: When hypertonicity is reversed by the correction of hyperglycemia or renal elimination of the contrast material, serum sodium concentration is normalized.