Hyponatremia is the most common electrolyte disorder encountered in clinical practice.[1]Lawless SJ, Thompson C, Garrahy A. The management of acute and chronic hyponatraemia. Ther Adv Endocrinol Metab. 2022 May 14;13:20420188221097343.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9109487
http://www.ncbi.nlm.nih.gov/pubmed/35586730?tool=bestpractice.com
[6]Giordano M, Ciarambino T, Castellino P, et al. Diseases associated with electrolyte imbalance in the ED: age-related differences. Am J Emerg Med. 2016 Oct;34(10):1923-1926.
https://www.doi.org/10.1016/j.ajem.2016.05.056
http://www.ncbi.nlm.nih.gov/pubmed/27475041?tool=bestpractice.com
It is estimated to occur in 5% to 35% of all hospital inpatients; however, the prevalence varies among studies.[2]Spasovski G, Vanholder R, Allolio B, et al; Hyponatraemia Guideline Development Group. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Eur J Endocrinol. 2014 Feb 25;170(3):G1-47.
http://www.eje-online.org/content/170/3/G1.long
http://www.ncbi.nlm.nih.gov/pubmed/24569125?tool=bestpractice.com
[3]Adrogué HJ, Tucker BM, Madias NE. Diagnosis and management of hyponatremia: a review. JAMA. 2022 Jul 19;328(3):280-91.
http://www.ncbi.nlm.nih.gov/pubmed/35852524?tool=bestpractice.com
It should be noted that the serum sodium concentration used to define hyponatremia varies among studies.
In a large, US-based cohort study that assessed over 50,000 hospital admissions, the prevalence of hyponatremia on admission was found to be 37.9%.[7]Wald R, Jaber BL, Price LL, et al. Impact of hospital-associated hyponatremia on selected outcomes. Arch Intern Med. 2010 Feb 8;170(3):294-302.
http://www.ncbi.nlm.nih.gov/pubmed/20142578?tool=bestpractice.com
An additional 38% of patients in this study with a normal initial sodium level developed hyponatremia during admission. Most cases (79%) of hyponatremia in the study were considered to be very mild (i.e., 133-137 mEq/L), 15.2% were mild (128-132 mEq/L), 3.7% moderate (123-127 mEq/L), and 1.7% severe (<122 mEq/L).
In another large, US-based cohort study that assessed over 198,000 hospital admissions, the prevalence of hyponatremia on admission was found to be 5.5%.[8]Zilberberg MD, Exuzides A, Spalding J, et al. Epidemiology, clinical and economic outcomes of admission hyponatremia among hospitalized patients. Curr Med Res Opin. 2008 Jun;24(6):1601-8.
http://www.ncbi.nlm.nih.gov/pubmed/18426691?tool=bestpractice.com
Other smaller studies have found the prevalence of hyponatremia to range between 7% and 11% in ambulatory outpatients.[9]Verbalis JG, Grossman A, Höybye C, et al. Review and analysis of differing regulatory indications and expert panel guidelines for the treatment of hyponatremia. Curr Med Res Opin. 2014 Jul;30(7):1201-7.
http://www.ncbi.nlm.nih.gov/pubmed/24809970?tool=bestpractice.com
A retrospective cohort study demonstrated that moderate hyponatremia (125-130 mEq/L) and severe hyponatremia (<125 mEq/L) were present in 2.7% and 1.2% of patients, respectively, on admission to intensive care units.[10]Funk GC, Lindner G, Druml W, et al. Incidence and prognosis of dysnatremias present on ICU admission. Intensive Care Med. 2010 Feb;36(2):304-11.
http://www.ncbi.nlm.nih.gov/pubmed/19847398?tool=bestpractice.com
Hyponatremia is common in elderly people, especially those who are hospitalized or living in nursing homes.[11]Braun MM, Barstow CH, Pyzocha NJ. Diagnosis and management of sodium disorders: hyponatremia and hypernatremia. Am Fam Physician. 2015 Mar 1;91(5):299-307.
http://www.aafp.org/afp/2015/0301/p299.html
http://www.ncbi.nlm.nih.gov/pubmed/25822386?tool=bestpractice.com