Mechanisms of hyponatraemia in alcohol patients

Hyponatraemia is commonly reported in chronic alcoholic patients. However, the underlying pathogenetic mechanisms are not well delineated. In the curr ent study, we analysed the possible pathophysiological mechanisms of hypona traemia in a group of alcoholic patients (n = 127) admitted to our hospital for causes related to alcohol misuse. Hyponatraemia (serum sodium <134 mmo l/l) was found in 22 patients (17.3%). The most common cause of hyponatraem ia in our cohort was hypovolaemia (12 patients); pseudohyponatraemia was di agnosed in six patients with alcohol-induced severe hypertriglyceridaemia. It is of interest that two patients fulfilled the criteria of the so-called 'beer potomania' syndrome, while in two others, hyponatraemia was due to r eset osmostat or to cerebral salt wasting syndrome, not previously describe d in alcoholic patients. It is concluded that hyponatraemia is a frequently observed electrolyte disorder in hospitalized alcoholic patients and is re lated to various pathophysiological mechanisms.