As it has been demonstrated in the previous posts of this series, hyponatremia can be caused by multiple pathophysiological processes. It is the expertise of the internist and the nephrologist to determine the mechanism of disease in order to provide the most adequate treatment. Hyponatremia is a very common condition and fortunately it is easily diagnosed once the patient is in the hospital. The challenge appears when the patient allows too much time to pass being ill before showing up to a healthcare center.

The changes which happen in the body as a consequence of hyponatremia are all related to the movement of water from the extracellular space to the intracellular space and have their most significant consequences in the brain tissue because it is surrounded by a hard shell called the skull. As a consequence of this, he main signs and symptoms of hyponatremia are neurological.

The treatment of hyponatremia can be as simple as restricting water and as complicated as providing V2 receptor blockers or medications such as demeclocycline. The decision to provide one or the other is based on the history of the disease process, the physical findings and the expertise of the physician in charge of the case. Finally, hyponatremia, once resolved, in most cases, does not leave sequelae. However, there is one condition that has to be kept always in mind. It is the osmotic demyelination syndrome (OMS) which may occur if hyponatremia is resolved too fast.