RT Journal Article SR Electronic T1 Salt and water: a simple approach to hyponatremia JF Canadian Medical Association Journal JO CMAJ FD Canadian Medical Association SP 365 OP 369 VO 170 IS 3 A1 Karen E. Yeates A1 Michael Singer A1 A. Ross Morton YR 2004 UL http://www.cmaj.ca/content/170/3/365.abstract AB HYPONATREMIA IS COMMON IN BOTH INPATIENTS and outpatients. Medications are often the cause of acute or chronic hyponatremia. Measuring the serum osmolality, urine sodium concentration and urine osmolality will help differentiate among the possible causes. Hyponatremia in the physical states of extracellular fluid (ECF) volume contraction and expansion can be easy to diagnose but often proves difficult to manage. In patients with these states or with normal or near-normal ECF volume, the syndrome of inappropriate secretion of antidiuretic hormone is a diagnosis of exclusion, requiring a thorough search for all other possible causes. Hyponatremia should be corrected at a rate similar to that at which it developed. When symptoms are mild, hyponatremia should be managed conservatively, with therapy aimed at removing the offending cause. When symptoms are severe, therapy should be aimed at more aggressive correction of the serum sodium concentration, typically with intravenous therapy in the inpatient setting.