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Hypovolaemic, greatly reduced Na, reduced water

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • renal:
    • diuretic therapy
    • salt losing nephritis
    • cerebral salt wasting
    • mineralocorticoid deficiency (1)
    • arenal hemorrhage
    • adrenal enzyme deficiencies (congenital adrenal hyperplasia)
    • bicarbonaturia, glucosuria, ketonuria

  • non-renal:
    • vomiting
    • diarrhoea
    • pancreatitis
    • burns (1)

Notes:

  • HONK - serum sodium may be low, even if the patient is severely hyperosmolar, due to redistribution of fluid into the extracellular fluid. When the patient is very dehydrated, there may be hypernatraemia.
  • DKA - the same mechanism as for HONK

Reference:

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