{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:01:51Z","timestamp":1791849711062,"version":"4.3.4"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2007,2,22]],"date-time":"2007-02-22T00:00:00Z","timestamp":1172102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2007,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background: <\/jats:bold> Hyponatraemia is associated with substantial morbidity and mortality. Identification of the risk factors associated with the development of symptomatic hyponatraemia is important in determining preventive strategies.<\/jats:p><jats:p><jats:bold>Methods: <\/jats:bold> A retrospective analysis of the risks factors associated with the development of severe, symptomatic hyponatraemia requiring hospital admission over the past 3\u2003years at our institution was carried out.<\/jats:p><jats:p><jats:bold>Results: <\/jats:bold> Forty\u2010seven patients (26 women, 21 men) with a hospital admission serum sodium &lt;134\u2003mmol\/L were identified. Of these patients, 31 (65.9%) had associated changes in the mental status that improved with the treatment of the hyponatraemia suggesting causality. The average admission sodium level of this cohort was 118.8\u2003mmol\/L. Symptomatic hyponatraemia was associated with volume depletion (32.6%), congestive heart failure (26%), syndrome of inappropriate antidiuretic hormone (26%), thiazide diuretic use (26%) and selective serotonin re\u2010uptake inhibitor use (26%). In 21.7% of cases, the cause was multifactorial (congestive heart failure, syndrome of inappropriate antidiuretic hormone or medication use with volume depletion). In 11% of cases, patients were taking both thiazide diuretics and serotonin re\u2010uptake inhibitors. Most importantly, 70.9% of all patients admitted with symptomatic hyponatraemia had pre\u2010existing hyponatraemia that was untreated and believed to be asymptomatic (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.05). This was the most common risk factor identified. We next investigated the prevalence of presumed asymptomatic hyponatraemia in the outpatient setting. Out of 27\u2003496 patients analysed, 14% had serum sodium levels less than or equal to 134\u2003mEq\/L and 4% had values less than 130\u2003mEq\/L.<\/jats:p><jats:p><jats:bold>Conclusion: <\/jats:bold> Pre\u2010existing asymptomatic hyponatraemia is a common finding and is associated with a high risk for the development of worsening hyponatraemia with altered mental status.<\/jats:p>","DOI":"10.1111\/j.1445-5994.2006.01294.x","type":"journal-article","created":{"date-parts":[[2007,2,22]],"date-time":"2007-02-22T10:47:45Z","timestamp":1172141265000},"page":"149-155","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Risk factors for symptomatic hyponatraemia: the role of pre\u2010existing asymptomatic hyponatraemia"],"prefix":"10.1111","volume":"37","author":[{"given":"M.","family":"Bissram","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. 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