Pathophysiology, Diagnosis and Management of Hyponatremia


  • Mechanisms that regulate sodium and water
  • Management of acute symptomatic hyponatremia
  • Patients at risk of osmotic demyelination syndrome and how to prevent it

This post reviews more in depth the pathophysiology and management of hyponatremia. The website itself serves as the teaching platform or as a learning resource. For a quick and easy diagnostic approach to hyponatremia, please see our 3 Lab Approach to Diagnosis.

Pathophysiology Review: 

Diagnostic Work-up and Management: 



  1. Verbalis, et al. 2007. Hyponatremia Treatment Guidelines 2007: Expert Panel Recommendations. The American Journal of Medicine. 120(11A): S1-S21.
  2. Sterns, RH, et al. 2013. Management of Hyponatremia in the ICU.  CHEST. 144(2): 672-279.
  3. Barrisford, GW & Steele, GS.  Acute urinary obstruction. In: UpToDate, Libman, H (Ed), UpToDate, Waltham, MA. (Accessed on May 25,2017)
  4. Sterns, RH.  Overview of treatment of hyponatremia in adults. In: UpToDate, Forman, JP (Ed), UpToDate, Waltham,  MA. (Accessed on May 25, 2017)
  5. Buffington, MA & Abreo, K. 2016. Hyponatremia: A Review. Journal of Intensive Care Medicine. 31(4) 223-236
  6. Hoorn, EJ & Ziestse, R. 2017. Diagnosis and Treatment of Hyponatremia: Compilation of the Guidelines. Journal of the American Society of Nephrologists. 28:1340-1349.