What does Pseudohyponatremia mean

Pseudohyponatremia is an uncommonly encountered laboratory abnormality defined by a serum sodium concentration of less than 135 mEq/L in the setting of a normal serum osmolality (280 to 300 mOsm/kg).

How is Pseudohyponatremia detected?

Pseudohyponatremia is an artefact; measured serum sodium is reduced but actual plasma sodium is normal. The condition can only arise if the serum lipid or protein concentration is markedly increased and plasma sodium is measured using either indirect ISE or flame photometer.

What is the most common cause of hyponatremia?

Hyponatremia is decrease in serum sodium concentration < 136 mEq/L (< 136 mmol/L) caused by an excess of water relative to solute. Common causes include diuretic use, diarrhea, heart failure, liver disease, renal disease, and the syndrome of inappropriate antidiuretic hormone secretion (SIADH).

What is Pseudohypernatremia?

DEFINING PSEUDOHYPERNATREMIA Pseudohypernatremia is defined as spuriously increased plasma sodium (>145 mmol/L) due to decreased plasma protein concentration. Theoretically at least, decreased blood lipids would have the same effect but reduction in blood lipids of sufficient severity is extremely rare.

How does glucose cause Pseudohyponatremia?

Hyperglycemia causes osmotic shifts of water from the intracellular to the extracellular space, causing a relative dilutional hyponatremia.

Do you code pseudohyponatremia?

As such, pseudohyponatremia cannot be coded, and coding efforts should focus on identifying the inciting cause.

How does hyperlipidemia and Hyperproteinemia cause pseudohyponatremia?

In states of hyperproteinemia or hyperlipidemia, there is an increased mass of the nonaqueous components of serum and a concomitant decrease in the proportion of serum composed of water. Thus, pseudohyponatremia results because the flame photometry method measures sodium concentration in whole plasma.

What is Translocational hyponatremia?

Translocational hyponatremia refers to the translocation of water from the ICF compartment to the ECF compartment usually in the setting of hypertonicity, which dilutes the PNa. This most commonly occurs with hyperglycemia but can also occur with mannitol, glycine, and maltose.

Does alcohol cause Pseudohyponatremia?

Other potential causes of hyponatremia in patients with a history of alcohol use disorder include liver cirrhosis, syndrome of inappropriate antidiuretic hormone, cerebral salt wasting syndrome due to alcohol-induced cerebral atrophy, heart failure, hypovolemia, and pseudohyponatremia secondary to alcohol-induced …

What is hypovolemic hyponatremia?

Hypovolemic hyponatremia is a result of fluid losses either from the kidneys (most commonly due to iatrogenic overdiuresis) or from the gastrointestinal tract (i.e., diarrhea). Patients typically will have signs of dehydration and findings of prerenal azotemia due to the contraction of the total plasma volume.

Article first time published on

What organs are affected by hyponatremia?

Hyponatremia can result from multiple diseases that often are affecting the lungs, liver or brain, heart problems like congestive heart failure, or medications.

Will eating salt help hyponatremia?

In elderly patients with a diet poor in protein and sodium, hyponatremia may be worsened by their low solute intake. The kidney’s need to excrete solutes aids in water excretion. An increase in dietary protein and salt can help improve water excretion.

Which of the following are causes of hyponatremia in older adults?

Hyponatremia in elderly subjects is mainly caused by drugs (more frequently thiazides and antidepressants), the syndrome of inappropriate antidiuretic hormone secretion (SIAD) or endocrinopathies; however, hyponatremia is multifactorial in a significant proportion of patients.

Why does hypertriglyceridemia cause hyponatremia?

Pseudohyponatremia is a well-documented artificial phenomenon in severe hypertriglyceridemia (HTG). When using indirect potentiometry, the measured sodium concentration per volume of plasma is falsely low despite a constant sodium concentration in the water phase, because lipid displaces water content in the plasma.

How is hyperosmolar hyperglycemic state diagnosed?

1. Plasma glucose level of 600 mg/dL or greater.
2. Effective serum osmolality of 320 mOsm/kg or greater.
3. Profound dehydration, up to an average of 9 L.
4. Serum pH greater than 7.30.
5. Bicarbonate concentration greater than 15 mEq/L.

What causes hyperglycemia?

Many factors can contribute to hyperglycemia, including: Not using enough insulin or oral diabetes medication. Not injecting insulin properly or using expired insulin. Not following your diabetes eating plan.

What is reset Osmostat?

Reset osmostat, a subtype of syndrome of inappropriate antidiuretic hormone secretion, is a rare cause of hyponatraemia, which is characterised by a decrease of the threshold of plasma osmolality for the excretion of antidiuretic hormone.

What causes Hyperproteinemia?

Dehydration. Chronic (long-term) inflammation or inflammatory disorders. Infections caused by viruses, such as hepatitis B, hepatitis C or HIV/AIDS. Certain cancers, like multiple myeloma, sarcoidosis and Waldenstrom macroglobulinemia.

What causes low blood osmolality?

Abnormally low blood osmolality can be caused by several conditions, including: excess fluid intake or over hydration. hyponatremia, or low blood sodium. paraneoplastic syndromes, a type of disorder that affects some people with cancer.

What is the ICD 10 code for Pseudohyponatremia?

ICD-10-CM Diagnosis Code E34 E34.

Why do lipids cause Pseudohyponatremia?

The most common cause of pseudohyponatremia is due to severely elevated levels of cholesterol. [2] In serum blood samples taken from patients with severe hypertriglyceridemia, the sample may appear overtly lipemic, hyper viscous, or discolored from the overwhelming presence of insoluble triglycerides.

What is the ICD 10 code for hyperglycemia?

R73. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM R73. 9 became effective on October 1, 2021.

Why do alcoholics become Hyponatremic?

Alcoholic beer drinkers like this patient are at high risk of developing hyponatremia due to their low-protein, high-water diet. Very low dietary solute intake (compared with water intake) leads to extremely low urinary solute excretion that exceeds the maximal urinary dilution capacity.

Why do alcoholics eat salt?

Sodium is an important electrolyte. When someone with chronically low sodium levels routinely binges on beer or other alcoholic beverages, especially when they also have poor overall nutrition, the kidneys can become dysfunctional. Fluid builds up in the cells because there isn’t enough sodium in the body.

Whats the best beer for you?

• Yuengling Light Lager.
• Abita Purple Haze.
• Guinness Draught.
• Sam Adams Light Lager.
• Deschutes Brewery Da Shootz.
• Full Sail Session Lager.
• Pacifico Clara.
• Sierra Nevada Pale Ale.

What is Hypochloremic?

Hypochloremia is when you have a low level of chloride in your blood. This could be due to a wide variety of conditions.

How do you control Dilutional hyponatremia?

Water restriction is a slow and difficult way to treat dilutional hyponatremia during diuretic therapy of congestive heart failure. An i.v. infusion of 400-1 400 mmol hypertonic saline combined with repeated i.v. injections of loop diuretics was used instead in 9 cases (6 patients).

What condition may result in hyperkalemia?

The most common cause of genuinely high potassium (hyperkalemia) is related to your kidneys, such as: Acute kidney failure. Chronic kidney disease.

What are 3 types of hyponatremia?

Hypovolemic hyponatremia: decrease in total body water with greater decrease in total body sodium. Euvolemic hyponatremia: normal body sodium with increase in total body water. Hypervolemic hyponatremia: increase in total body sodium with greater increase in total body water.

What are the three types of hyponatremia?

Hyponatremia is classified as pseudo hyponatremia, true and translocational hyponatremia [Figure 1]. Normal serum osmolality is 280-295 mosm/kg.

How is Hypervolaemic hyponatraemia treated?

37 In patients with hypervolemic hyponatremia, fluid and sodium restriction is the preferred treatment. Loop diuretics can be used in severe cases. 38 Hemodialysis is an alternative in patients with renal impairment.