Talk:Hyponatremia

message: In Seattle, a radio station held a water drinking contest for a Nintendo Wii console. Jennifer Lea Strange, a 28 year old mother of 3, entered, won, & died from "water intoxication" or Hyponatremia & the staff was fired. Marry Christmas kids, I hope your mom wasn't single. http://seattletimes.nwsource.com/html/nationworld/2003529990_water18.html  —Preceding unsigned comment added by 67.160.77.255 (talk) 04:30, 26 November 2008 (UTC)
replies: text: It's already there. Dan Levy (talk) 14:31, 26 November 2008 (UTC)
replies: text: The woman was in Sacramento, not Seattle!  —Preceding unsigned comment added by Loflorian (talk • contribs) 06:52, 9 January 2010 (UTC)
replies: text: And it should not be part of the article. Fullness of bladder has no impact on the concentration of sodium in blood or tissues. Her illness and death were caused by drinking too much water, not the fact that she was also trying to not urinate. David notMD (talk) 00:04, 22 September 2017 (UTC)
thread_title:  Can this be added to Notable Cases? 

message: The 2nd paragraph includes examples of diseases that fit in these various categories of causes. I propose that the diseases under each category be moved to the body of the article along with the references. That would remove 11 diseases, most of which the general reader has never heard of, and only obscures the big picture of what the categories are. Nothing is omitted - just moved from the introductory "big idea" paragraph - the Lead.
What would be moved is:
"Cases in which the urine is dilute include adrenal insufficiency, hypothyroidism, and drinking too much water or too much beer. Cases in which the urine is concentrated include syndrome of inappropriate antidiuretic hormone secretion (SIADH). High volume hyponatremia can occur from heart failure, liver failure, and kidney failure. Conditions that can lead to falsely low sodium measurements include high blood protein levels such as in multiple myeloma, high blood fat levels, and high blood sugar."
What would remain is: 
"The causes of hyponatremia are classified by a person's fluid status into low volume, normal volume, and high volume.  Normal volume hyponatremia is divided into cases with dilute urine and concentrated urine. There are also conditions that cause a falsely low serum sodium, called factitious hyponatremia." 
Thoughts, anyone? IiKkEe (talk) 04:53, 19 September 2017 (UTC)
thread_title:  Proposal to trim 2nd paragraph of Lead 

message: I have never been a fan of the "low-normal-high volume" approach to categorizing the causes of hyponatremia. This a quote from Chapter 44 Sterns RH of Seldin's and Giebich's The Kidney (which of course can't be used as such: COPYVIO), but I place it here as support for a new approach to categorizing the causes of hyponatremia. I plan to add the new approach to the Body without disturbing the old approach - but there's only room for one in the Lead, so I will only mention the old approach there. This will as usual be fair game for editing, reverting and discussing here once I get it in place The following describes the pitfalls of the old approach better than I can:
HYPOTONIC HYPONATREMIA: CLASSIFICATION AND PATHOGENESIS
"Traditionally,  patients  with  hyponatremia  are
divided into categories according to their body sodium
content  and/or  intravascular  volume:  low  body
sodium content (volume depletion); high body sodium
content  (edematous  conditions)  or  normal  body
sodium content (euvolemic hyponatremia or SIADH).
Although  this  time-honored  approach  is  often
helpful to clinicians, intravascular volume and body
sodium content do not always change in parallel (e.g.,
self-induced water intoxication), and some causes of
hyponatremia (e.g., diuretic-induced and cerebral salt-
wasting) may be difficult to classify by intravascular
volume. Moreover, physiologic responses to extracellu-
lar volume expansion and contraction often create
ambiguities in volume status. Thus, secondary water
retention in response to volume depletion and second-
ary natriuresis in response to water overload may ulti-
mately yield similar values for total body sodium and
water."
I'll get started after some sleep.  RegardsIiKkEe (talk) 06:01, 17 September 2017 (UTC)
replies: text: What are you proposing adding exactly? What is the "new approach" they are suggesting? Doc James (talk · contribs · email) 17:07, 18 September 2017 (UTC)
replies: text: @talk  I've already added it, under section Pathophysiology. It's a different approach to categorizing, not management. It replaces "low-normal-high volume" categories with three new categories based on urine volume ("impairment of urine diluting ability"), and ADH levels. The section should probably be titled "Alternate categorization". I'm still working on that section to fine tune it. — Preceding unsigned comment added by IiKkEe (talk • contribs) 22:17, 18 September 2017 (UTC)
thread_title:  New approach to categorizing causes of hyponatremia 

message: I have not contributed to the construction of this section or edited it, but I am concerned with how few references it has. It has an introduction and four subsections: the five references for these five parts are distributed 0,0,1,5, and 0. One was used twice.
I'm going to sprinkle the section with "citation needed" flags, but that doesn't help make the Article any better. Anyone interested in editing and referencing? 
One thing that definitely needs to be addressed is explaining what "volume" means in this section. I've asked a few high school kids to read the Lead and this section, and then asked what they think is meant by volume, they all said "urine volume". Click on the "low volume" link and at that site ("Hypovolemia") there is an incorrect definition, with no explanation of the various body fluid compartments and subcompartments and their relationships. Just three sentences and three references: one from the dictionary, two from Medterms.com.
Work to do...
Regards IiKkEe (talk) 23:40, 18 September 2017 (UTC)
replies: text: Hypovolemia is literally Latin for low volume.. Doc James (talk · contribs · email) 03:47, 19 September 2017 (UTC)
replies: text: Every sentence in the lead is referenced to a high quality recent secondary source. Doc James (talk · contribs · email) 16:13, 19 September 2017 (UTC)

text: Yes please go ahead and add further references to support the causes section. Doc James (talk · contribs · email) 01:47, 20 September 2017 (UTC)

text: Have updated. Was mostly correct Doc James (talk · contribs · email) 19:13, 20 September 2017 (UTC)
thread_title:  Causes section: paucity of references 

message: Why was this removed?
"There is tentative evidence that vasopressin receptor antagonists (vaptans), such as conivaptan, may be slightly more effective than fluid restriction in those with high volume or normal volume hyponatremia. They should not be used in people with low volume. Their use in SIADH is unclear."
And replaced with point for content supported by older sources?
Doc James (talk · contribs · email) 16:16, 19 September 2017 (UTC)
replies: text: Okay thanks. Doc James (talk)contribs · email) 16:12, 20 September 2017 (UTC)
replies: text: I have removed all bullet points as we should be writing in prose not bullet points. Doc James (talk · contribs · email) 18:26, 20 September 2017 (UTC)

text: @talk Bullets or no bullets: either way is OK by me - thought it odd that one sentence was "non-bullet", everything else was "bullet", and they should all be one way or the other.
I do have a question for you on this subsection. I know nothing about these meds, but based on what is written here, I conclude that none is really worth a hoot. Do you think an introductory sentence something like "None of the medications discussed here has a significant role to play in the treatment of hyponatremia" or something to that effect? Just a suggestion. IiKkEe (talk) 05:08, 21 September 2017 (UTC)

text: There use is controversial. The source you added concluded that the US and EU guidelines came to different conclusions. Meds have limited use as a second / third line therapy. That is to say they have a small role maybe. We just need to base on the conclusions of the sources. Doc James (talk · contribs · email) 05:15, 21 September 2017 (UTC)

text: How is this ? The exact wording I used above is not supported by the current source and we would need to find another source. Doc James (talk · contribs · email) 17:29, 22 September 2017 (UTC)
thread_title: Why is well referenced prose being removed

message: I would argue that glucose and mannitol caused hyponatremia (hypertonic) shouldn’t be considered ‘pseudo’hyponatraemia. Considering that in those cases the sodium is actually'’ low. Compared to hyperlipidaemia when the sodium levels are normal, but the lab test reads low.
FreeT (talk) 22:47, 26 March 2018 (UTC)
thread_title:  True vs False hyponatraemia? 

message: Hyponatremia is also spelled hyponatraemia in British English, Australian English, etc. Please don't edit out '(also: hyponatraemia)' in the article. There is no good reason not to include the alternative spelling.  — Preceding unsigned comment added by 2A00:23C5:DA0E:CC00:B9AC:4A00:1777:F2EB (talk) 10:59, 12 March 2020 (UTC)
replies: text: I don't find it suitable that 'hyponatraemia' is merely listed in an info box as an alternative name. It isn't an alternative name. It's an alternative spelling. On the page for sulfur, it doesn't consign the alternative spelling 'sulphur' to an info box as an alternative name. — Preceding unsigned comment added by 2a00:23c5:da0e:cc00:44d8:17f5:419a:6bce (talk) 10:36, 23 March 2020 (UTC)
thread_title:  Spelling 

message: A discussion is taking place to address the redirect :Too much water. The discussion will occur at Wikipedia:Redirects for discussion/Log/2021 July 4#Too much water until a consensus is reached, and readers of this page are welcome to contribute to the discussion.  signed, Rosguill talk 18:54, 4 July 2021 (UTC)
thread_title:  "Too much water" listed at [[Wikipedia:Redirects for discussion|Redirects for discussion]] 

message: In an anthropology article, I've heard that in areas where zombie making is a real thing (read Haiti as the main area), people who use them for slave labor subject them to various mistreatments designed to keep them in line and keep them apathetic, in particular, food deprivation, and most notably, sodium deprivation. This would of course be a case of chronic hyponatremia. Since the article doesn't say a thing about the chronic effects of sodium deficiency, could somebody explain if this is a superstitious thing, of if that deprivation really does what it is supposed to? Svartalf (talk) 03:42, 29 October 2022 (UTC)
thread_title:  Hyponatremic zombies?