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Relevance of uric acid levels in hyponatremia management

Shafiq Ahmed and Iqbal Ur Rehman

Introduction: Hyponatremia is a common electrolyte disorder seen in routine clinical practice with diverse etiologies and manifestations. Patient’s volume status assessment and to know the type of hyponatremia is of key value in the management of hyponatremia. This study is aimed to determine the frequency of hypouricemia and hyper uricemia in euvolemic and volume depleted patients of hyponatremia. Aim: To determine the frequency of euvolemia and hypovolemia in patients of hyponatremia and to compare the frequency of hpouricemia and hyperuricemia in euvolemic and volume depleted patients of hyponatremia. Study Design: This was a descriptive case series study. Study Setting: This study was conducted in Emergency department of Shifa International Hospital, Islamabad from February, 2014 to August, 2014. Subjects and Method: 156 hyponatremic patients, 18 years and above from both genders were included in the study. Volume status of the patients assessed and patients were divided into euvolemic and hypovolemic groups. Serum uric acid of all the patients was checked. A standard Performa was used to collect the data and SPSS 16 version was to analyze the data. Results: Mean age was 55.22 years with a range of 19 to 90 years. 54.5% were male and 45.5 % were females. In the study 97.2% hypovolemic patients showed hyperuricemia and among euvolemic patients 92.9% had uric acid less the 6 mg/dl. Fisher’s Exact Test showed derived p-value of .000 showing a significant relation of hypo and hyper uricemia with euvolemic and volume depleted patients of hyponatremia. Conclusion: Hyponatremia is a common disorder with diverse etiologies and clinical manifestations. Apart from a good clinical evaluation serum uric acid is very helpful in discriminating two subsets of hyponatemia one with euvolemia and other with volume depleted state. Clinicians need to be aware of this diagnostic role of serum uric acid in hyponatremia.