Hyponatremia is a complex electrolyte disorder defined by reduced serum sodium concentration and is associated with significant neurological morbidity if improperly managed. The risk of treatment lies not only in under correction but also in overly rapid correction, which can cause osmotic demyelination syndrome (ODS).

At IMH, hyponatremia correction is managed through nephrology-led, protocol-based stratification, focusing on:

Severity of sodium reduction

Symptom burden

Rate of onset (acute vs chronic)

Underlying pathophysiology

Patients with severe symptomatic hyponatremia (seizures, coma, altered mental status) receive immediate treatment with controlled hypertonic saline under ICU monitoring. Correction rates are strictly limited to prevent neurological injury.

For chronic or asymptomatic cases, treatment may include:

Fluid restriction

Discontinuation of causative medications

Targeted therapy for SIADH

Controlled sodium supplementation

Serial sodium measurements guide therapy, with correction targets adjusted dynamically. Advanced cases may require vasopressin receptor antagonists under specialist supervision.

IMH emphasizes precision correction, continuous neurological monitoring, and strict adherence to safe correction thresholds to optimize outcomes and prevent iatrogenic harm.