The sodium concentration in the blood and in the cells is maintained within a very tight range. It allows all of the cellular mechanisms to run optimally. Variations from this level may occur in illness. The sodium in the blood may be increased or decreased. Regulation of the sodium concentration is regulated by the hypothalamus of the brain. This portion of the brain releases hormones through the pituitary gland that controls the levels of water and sodium in the body. Abnormal sodium levels can affect all the cells of the body.
Causes of Sodium Imbalance
Loss of sodium or reabsorption of excess water may produce hyponatremia. In addition, edema secondary to heart failure, cirrhosis of the liver and nephrotic syndrome may produce hyponatremia. Elevated glucose levels and elevated lipid levels in the blood may also produce pseudohyponatremia. Elevated levels of sodium, or hypernatremia, usually occur from water loss. Dehydration or lack of water can lead to hypernatremia. Excessive urination caused by lack of anti-diuretic hormone can produce elevated levels of sodium. This form of water loss, diabetes insipidus, is common after brain injuries, hemorrhages within the brain and meningitis. Some forms of diarrhea, especially osmotic diarrheas, can produce hypernatremia. Diuretics that work on the kidneys can produce hypernatremia.
Signs and Symptoms of Sodium Imbalance
Many of the clinical features of hyponatremia relate to brain swelling and cerebral edema. The development and severity of symptoms is also related not only to the degree of hyponatremia, but also the rate at which the sodium concentration in the body is changing. Early on, nausea, vomiting, and fatigue occur. Later, headache, lethargy and confusion develop. Only at severe states do seizures or coma develop. Hypernatremia is usually produced by loss of water. There is often altered mental status. Weakness and muscular irritability occur. Bleeding in the brain may develop, leading to weakness, numbness or speech problems. Seizures and coma can occur.
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Medical Content Last Updated on 07/12/2008
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