From the Research
Pseudohyponatremia is a laboratory artifact that requires careful diagnosis and management to prevent misdiagnosis and inappropriate treatment, and the most effective approach is to address the underlying condition rather than correcting sodium levels directly, as emphasized in the most recent study 1.
Definition and Causes
Pseudohyponatremia is a condition where serum sodium concentration appears falsely low due to increased plasma lipids or proteins, which occupy more volume in the blood sample, causing a proportional decrease in the water fraction where sodium is measured. Common causes include severe hyperlipidemia, hyperproteinemia, and hyperglycemia.
Diagnosis
Diagnosis involves measuring plasma osmolality, which remains normal in pseudohyponatremia but is low in true hyponatremia. It is crucial to distinguish pseudohyponatremia from true hyponatremia to avoid inappropriate and potentially harmful sodium correction, as highlighted in a recent study 2.
Treatment
Treatment should focus on addressing the underlying condition rather than correcting sodium levels directly. For example, treating hyperlipidemia, hyperproteinemia, or hyperglycemia will resolve the laboratory abnormality. The most recent study 1 emphasizes that pseudohyponatremia does not require treatment to address the sodium level, and any inadvertent correction treatment can be potentially detrimental.
Key Considerations
- Pseudohyponatremia typically does not exhibit symptoms of low sodium, such as confusion, seizures, or coma, because the effective osmolality remains normal.
- The use of indirect ion-specific electrodes can lead to pseudohyponatremia in patients with elevated serum solid content concentrations, as discussed in a recent study 1.
- Clinicians should be aware of the methods used by their clinical laboratory to measure serum sodium levels and interpret the results accordingly, as emphasized in an earlier study 3.
Clinical Implications
- Pseudohyponatremia can lead to serious morbidity and mortality if not recognized and managed properly, as highlighted in a recent study 2.
- The distinction between pseudohyponatremia and true hyponatremia is critical to prevent misdiagnosis and inappropriate treatment, which can have significant clinical implications, as discussed in a study 4.