Misleading Hyponatremia Due to Hyperlipemia: A Method-Dependent Error
Authors: JACK H. LADENSON
Journal: Annals of Internal Medicine (1981)

Brief Reports1 December 1981Misleading Hyponatremia Due to Hyperlipemia: A Method-Dependent ErrorJACK H. LADENSON, Ph.D., FRED S. APPLE, Ph.D., DAVID D. KOCH, Ph.D.JACK H. LADENSON, Ph.D., FRED S. APPLE, Ph.D., DAVID D. KOCH, Ph.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-95-6-707 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSerum from patients with hyperlipemia has been clearly shown to have low sodium values when analyzed by flame photometry (1-10). This artifactually low sodium value is due to a decrease in the percentage of water (water content) in serum or plasma. This decrease in water content leads to less sodium in a given volume aliquot of the sample taken for analysis even though the "concentration" of sodium in the water phase may be unaltered. Methods for measuring sodium in serum include the traditional technique of flame photometry or the more recent and increasingly used technique of potentiometry using a sodium...References1. ALBRINKHALDMANPETERS MPEJ. The displacement of serum water by the lipids of hyperlipemic serum. J Clin Invest. 1955;34:1483-8. CrossrefMedlineGoogle Scholar2. WAUGH W. Utility of expressing serum sodium per unit of water in assessing hyponatremia. Metabolism. 1969;18:706-12. CrossrefMedlineGoogle Scholar3. BELLHILTONWALKER JPG. Severe hyponatremia in hyperlipaemic diabetic ketosis. Br Med J. 1972;4:709-10. CrossrefMedlineGoogle Scholar4. STEFFESFREIER ME. A simple and precise method of determining true sodium, potassium, and chloride concentrations in hyperlipemia. J Lab Clin Med. 1976;88:683-8. MedlineGoogle Scholar5. LADENSON J. Direct potentiometric analysis of sodium and potassium in human plasma: evidence for electrolyte interaction with a nonprotein, protein-associated substance(s). J Lab Clin Med. 1977;90:654-65. MedlineGoogle Scholar6. DUNNESHENKINIMRIE MAC. Misleading hyponatremia in acute pancreatitis with hyperlipaemia. Lancet. 1979;1:211. Letter. CrossrefMedlineGoogle Scholar7. BURNGILL JG. Pseudonormonatraemia. Br Med J. 1979;2:1110-1. CrossrefMedlineGoogle Scholar8. FRIERSTEERBAIRDBLOOMFIELD BCJS. Misleading plasma electrolytes in diabetic children with severe hyperlipidaemia. Arch Dis Childhood. 1980;55:771-5. CrossrefMedlineGoogle Scholar9. Dangerous pseudohyponatraemia. Lancet. 1980;2:1121. Editorial. Google Scholar10. FORRESTSHENKIN AA. Dangerous Pseudohyponatraemia. Lancet. 1980;2:1256. Letter. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. 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