Serum Sodium
Blood Tests

Author: Gianpiero Pescarmona
Date: 13/11/2011



Serum sodium is a measurement of the level of sodium in the blood serum.

External links





Extracellular sodium drives:

  • sodium/proton exchange
  • Glucose uptake
  • Aminoacids uptake



Specificity, sensitivity etc.

Diagnostic Algorithms


Open Questions


Hyponatraemia is defined as a serum sodium concentration less than 130/133 mmol/L according to different studies.

SIADH and hyponatraemia: foreword. 2009

Hyponatraemia is common, affecting about one in five of all hospitalized patients

Cost of illness of hyponatremia in the United States, 2006

Hyponatremia is the most common electrolyte disorder encountered in clinical medicine .

Hyponatremia and aging

Sodium dependent multivitamin transporter (SMVT): a potential target for drug delivery. 2015

Sodium dependent multivitamin transporter (SMVT; product of the SLC5A6 gene) is an important transmembrane protein responsible for translocation of vitamins and other essential cofactors such as biotin, pantothenic acid and lipoic acid.

Hyponatremia symptoms

Causes of Hyponatremia:

  • Salt Restricted Diet

Syndrome of inappropriate antidiuretic hormone secretion: Revisiting a classical endocrine disorder, 2011

Hyponatremia associated with hyperglycemia

Current and future treatment options in SIADH. 2009

In the absence of end-stage renal failure, hyponatraemia usually represents a state of vasopressin-induced water retention.

In particular, the posterior pituitary hormone vasopressin leads to renal water retention and hyponatremia.



» More Relationships

The circadian oscillation of hundreds of biological processes enables a human body to adapt to 24-hour light/dark cycles. a) The serum levels of cortisol and aldosterone, and urine volume, oscillate in circadian cycles in humans . The cortisol level peaks in healthy individuals at early morning and reach their lowest levels before bedtime. Disruption of cortisol circadian rhythm can result in fatigue and restlessness, weight loss, insomnia and coronary heart disease. Aldosterone is a steroid hormone that is secreted by the cortex of the adrenal gland and regulates the body's electrolyte balance. The level of aldosterone is normally low during the day and high during sleep in humans. Disruption of aldosterone rhythms result in sodium and water retention, increased blood pressure and coronary heart disease. Urine volumes have inverted circadian oscillating patterns, compared to that of aldosterone, in healthy humans. b) The circadian oscillation of lymphocyte, monocyte, platelet and eosinophil levels in healthy young adults. The activity of the immune system, usually represented by the number of lymphocytes, peaks in the late evening and is lowest in the early morning. Disruption in this circadian rhythm could lead to immune suppression

The circadian clock: pacemaker and tumour suppressor, 2003

Causes of Hypernatremia:

Cortisol administration

Licorice abuse?

SSRI Hyponatremia SSRI

Working Hypothesis

Dietary Sodium Intake and Incidence of Diabetes Complications in Japanese Patients with Type 2 Diabetes – Analysis of the Japan Diabetes Complications Study (JDCS). 2014

  • Abstract
    Many guidelines recommend that patients with type 2 diabetes should reduce their dietary sodium intake. However, the relationship between dietary sodium intake and incidence of diabetic complications in patients with type 2 diabetes has not been explored.

To investigate the relationship between dietary sodium intake and incidence of diabetes complications.
Design, Setting, and Participants:

A nationwide cohort of patients with type 2 diabetes aged 40–70y with HbA1c ≥6.5%.
Main Outcome Measures:

After excluding non-responders to a dietary survey, 1588 patients were analyzed. Baseline dietary intake was assessed by the Food Frequency Questionnaire based on food groups. Primary outcomes were times to cardiovascular disease (CVD), overt nephropathy, diabetic retinopathy, and all-cause mortality.

Mean daily dietary sodium intake in quartiles ranged from 2.8 to 5.9g. After adjustment for confounders, hazard ratios (HRs) for CVD in patients in the second, third, and fourth quartiles of sodium intake compared with the first quartile were 1.70 (95% confidence interval, 0.98–2.94), 1.47 (0.82–2.62), and 2.07 (1.21–3.90), respectively (trend p<0.01). In addition, among patients who had HbA1c ≥9.0%, HR for CVD in patients in the top vs. bottom quartile of sodium intake was dramatically elevated compared with patients with HbA1c<9.0% (1.16 (0.56–2.39) and 9.91 (2.66–36.87), interaction p<0.01). Overt nephropathy, diabetic retinopathy, and all-cause mortality were not significantly associated with sodium intake.

Findings suggested that high dietary sodium intake is associated with elevated incidence of CVD in patients with type 2 diabetes and that there is a synergistic effect between HbA1c values and dietary sodium intake for the development of CVD.

2012-04-29T17:15:28 - Gianpiero Pescarmona

Hyponatremia SSRI

Sodium cell death

Hyponatremia apoptosis

Sodium apoptosis

Sodium deprivation apoptosis

When CSF sodium is high we have hypertension by AVP. But the real cause could be the reduced water production depending on poor oxygen supply

Sodium CSF brain

2012-03-11T16:24:50 - Gianpiero Pescarmona

Distribution in hospital outpatients

s-Sodium(Na) -(one month - Molinette)

Adult 136-145 mmol/L

>90 132-146 mmol/L

Sodium-daily loss (Urine 24h)

6-10 y M 41-115 mmol
6-10 y F 20-69 mmol

10-14 y M 63-177 mmol
10-14 y F 48-168 mmol

Adult 40-220 mmol

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