A STUDY ON HYPONATREMIA IN HOSPITALIZED PATIENTS.

Hyponatremia is a common electrolyte abnormality often detected asymptomatically it is also common is hospitalized patients also this study was conducted in Telangana and Andhra Pradesh. in 200 hospitalized patients 60 patients were having hyponatremia where serum sodium is less than 135 M.Eqll /lt. and average age is 62 years. Males patients are 45% and female patient are 55%. Cases of mortality were progressive real failure and sepsis.

Hyponatremia is a common electrolyte abnormality often detected asymptomatically it is also common is hospitalized patients also this study was conducted in Telangana and Andhra Pradesh. in 200 hospitalized patients 60 patients were having hyponatremia where serum sodium is less than 135 M.Eqll /lt. and average age is 62 years. Males patients are 45% and female patient are 55%. Cases of mortality were progressive real failure and sepsis.
Most cases of hyponatremia reflects water imbalance and abnormal water handling, not Na. Imbalance, indicate primary role of ADH is the pathophysilogy of hyponatremia (2) , Serum osmolality identifies isotonic and hypotonic hyponatremia although these case can be identifies by history or pervious lab. insliziation (3) clinically significant hyponatremia is relatively by common & is non specific in its presentation (4).

Aims and Objectives:-
Aims of the study is to know the causes and clinical features of hyponatremia is hospitalized patients.

Material and Methods:-
Patients admitted between March 2016 to Nov 2016 were taken into consideration. serum sodium less than 135 Meqll/ Lt and age more than 50 yrs. were included in this study .
when serum sodium is less than 126 M.eqll the plasma and urine sample are sent for measurements of osmolality by freezing point depression osmometers serum electrolytes and urine spot Na are measured by ion sensitive electrode method

Discussion:-
In our study the patients with serum sodium between 125-135m mol/L are rarely having any symptoms. The patients with serum sodium <125m mol/L was having CNS Symptoms like, lethargy, drowsiness irritability confusion, seizures CT Scan (plain & contract) of brain was done in all the patients and there was no structural abnormality and these symptoms are attributed to hyponatremina. There is increase in hospitalization because of increase in Co-morbid condition like hypertension(55%) Diabetes mellitus (48%) Ischemic heart disease (20%), and rental failure (2%) most of the patents are multiple drug like ARBS, ACE Inhibitors, diuretics and oral hypoglycemic agents. These drugs can interfere and predispose them to electrolyte imbalance with metabolism of various electrolytes.

Sex Distribution
The patient with CNS Symptom were treated with intravenous 3% saline infusion to raise their serum sodium levels by 0.5 m.mol/L per hour to maximum of 12 m.mol/L increase in serum per day. patients who did not have any central pontinemyelinoss is described as a rare complication of treatment of hyponatremia but recent data has (leave) shown that the rate of correction has little of with the 5.6.7 development of central pontinemyelinoss.
Appropriate correction of hyponatremia in patients with symptamtichyponatremia is recommended in accordance to the guideline for correction of hyponatremia, in general plasma sodium shall not be corrected to more than 25 to 130 m.eq/L assuming that total body water compises 50% of total body weight 1 m/kg of 3% sodium chloride will raise the plasma sodium by 1 meq/L (8).
In male's mortality is higher 28% when compared with female (10%) may be related to age related brain atrophy. On the basis of the results it appears that physical factors may be more dominate factor of the two in ensuring brain survival during hypontremia in elderly female subjects. Many studies show a higher mortability in the elderly patient with sever hyponatremia in 30% to 48% in our study the mortability is 26% and causes of death were coronary artery disease, cerebro vascular accidents, sever sepsis and progressive rental failure. (9) In our study the commnest cause of the hyponatremia was due to SIADH 32% followed by drugs 22% then rental salt wasting and Gastronitestinal loses. Most important factor is during induced as VII JNC recommended diuretics as front line drug for treatment of hypertension a word of caution should be maintained while prescribing duties to the patients especially elderly patients. (10) Conclusion:-In our study the mean age in 65yrs light preponderance to female patients that is female 55% and males 45%.