Endocrinologists at work: management of hyponatremia in clinical practice

Hyponatremia is the most frequent electrolyte disorder among hospitalized patients and its prevalence increases with age. Multiple conditions lead to a reduction of serum sodium concentration ([Na+]), but in about one-third of cases, the cause of this alteration is the Syndrome of Inappropriate Antidiuresis (SIAD). Noteworthy, hyponatremia, which may cause neurological and extra-neurological (e.g., psychological, skeletal, muscular) alterations, is associated with a more negative outcome in many clinical conditions, including cancer. On the other hand, the normalization of serum [Na+] has a beneficial effect on patients’ outcome. Therefore, in principle, every clinician should be familiar with the management of hyponatremia. However, the endocrinologist is usually considered as one the reference figures. A group of Italian endocrinologists with a solid expertize in the management of hyponatremia met on December 20, 2022, in order to discuss different issues related to real-life management of hyponatremia. The following is a summary of the proposed questions and the answers shared by the group