title: Inpatient hyponatraemia: adequacy of investigation and prevalence of endocrine causes.
abstract: This study assessed the effect of endocrine input on the investigation of hyponatraemia and examined the prevalence of endocrine causes of hyponatraemia. This single-centre, retrospective study included 139 inpatients (median age, 74 years) with serum sodium (Na) levels ≤128 mmol/l during hospitalisation at a UK teaching hospital over a three-month period. In total, 61.9% of patients underwent assessment of volume status and 28.8% had paired serum and urine osmolality, and Na measured. In addition, 14.4% of patients received endocrine input; 80% of these patients underwent full work-up of hyponatraemia compared with 5% of patients not referred to endocrine services (p < 0.001; relative risk, 15.86; 95% confidence interval, 7.17-31.06). The prevalence of adrenal insufficiency was 0.7%, but basal serum cortisol levels were not measured in around two-thirds of patients. Despite 26.7% of patients having abnormal thyroid function tests, no patient was diagnosed with severe hypothyroidism. More widespread provision of expert input should be considered.
authors: Centre for Neuroendocrinology, Royal Free Campus, University College Medical School, London, UK ploutarchos.tzoulis@nhs.net.
authors: Ploutarchos
authors: P
authors: Tzoulis
authors: Centre for Neuroendocrinology, Royal Free Campus, University College Medical School, London, UK.
authors: Pierre Marc
authors: PM
authors: Bouloux
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005938:Glucocorticoids / Q000097:blood; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007010:Hyponatremia / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D007177:Inappropriate ADH Syndrome / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012964:Sodium / Q000097:blood*; D013960:Thyroid Function Tests; D013974:Thyroxine / Q000097:blood
chemical_list: D005938:Glucocorticoids; D012964:Sodium; D013974:Thyroxine
keywords: Hyponatraemia; inappropriate ADH syndrome; investigation; sodium; vasopressin
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