Dr Nick Russell is dual trained as an Endocrinologist and General Physician. He has sessional appointments in both specialties at Austin Health in Melbourne. He also works in private practice and has research interests in andrology and hyponatraemia. He has recently been a member of the RACP Victorian State Committee and the RACP College Council.
Hyponatraemia For The Internal Medicine Physician
Hyponatraemia is the most common electrolyte disorder in hospitalised patients such that it will be familiar to every internal medicine physician. It causes symptoms, and is associated with worse clinical outcomes, readmission, and mortality across a wide range of medical conditions. In cases of chronic moderate and severe hyponatraemia, the goal is to achieve a balance between insufficient correction, and excessively rapid correction, which creates the risk of osmotic demyelination syndrome. This management aim is widely appreciated, but frequently not achieved. Overcorrection is a common iatrogenic complication, yet it is preventable with appropriate monitoring and due attention to some key pathophysiological concepts. Using recent case examples, this lecture will present a pathophysiological and practical approach to the prevention of overcorrection of hyponatraemia in hospitalized patients.