Hyponatraemia
Borders Intranet - Electrolyte Deficiency Lothian RefHelp Society for Endocrinology Guidance
Sodium depletion (e.g. salt-losing bowel, renal disease).
Prophylaxis of sodium chloride deficiency 4-8 tablets daily with water (max 20 tablets daily in severe depletion). Chronic renal salt wasting, up to 20 tablets daily with appropriate fluid intake.
Note: each tablet contains Na+ 10mmol.
Reconstitute one sachet with 200ml of water (freshly boiled and cooled for infants).
Note: five sachets when reconstituted with 1 litre of water provide Na+ 60mmol, K+ 20mmol, Cl-60mmol, citrate 10mmol, and glucose 90mmol.
Reconstitute one sachet with 200ml of water (freshly boiled and cooled for infants).
Note: five sachets when reconstituted with 1 litre of water provide Na+ 60mmol, K+ 20mmol, Cl-60mmol, citrate 10mmol, and glucose 90mmol.
Reconstitute one sachet with 200ml of water (freshly boiled and cooled for infants).
Note: five sachets when reconstituted with 1 litre of water provide Na+ 60mmol, K+ 20mmol, Cl-60mmol, citrate 10mmol, and glucose 90mmol.
Prescribing Notes:
- Treatment should be guided by cause of hyponatraemia and local guidelines should be consulted prior to prescribing.
- Any unused reconstituted solution of Dioralyte should be discarded after 1 hour unless stored in a fridge when it may be kept for up to 24 hours.
- Oral supplementation may be indicated in chronic conditions such as salt-losing bowel.
- Oral rehydration salts are first line treatment for acute mild - moderate diarrhoea.
- Hyponatraemia is common in hospital patients: in the absence of large GI losses the causes are almost always too much fluid. Also consider Syndrome of inappropriate antidiuretic hormone secretion (SIADH), or chronic diuretic use. Measure urine and serum osmolality and urine sodium before commencing treatment. Refer to local in-patient hyponatraemia guidelines for more information.
- See Syndrome of inappropriate antidiuretic hormone secretion (SIADH) recommendations in the Endocrine formulary chapter.
History Notes
20/04/2023
East Region Formulary content agreed.
1-2mmol/kg/day in divided doses, adjusted according to serum and urinary levels.
1-2mmol/kg/day in divided doses, adjusted according to serum and urinary levels.
Reconstitute one sachet with 200ml of water (freshly boiled and cooled for infants). This provides Na+ 15mmol, K+ 5mmol, Cl– 10mmol, citrate 2mmol, and glucose 18mmol.
1-2mmol/kg/day in divided doses, adjusted according to serum and urinary levels.
1-2mmol/kg/day in divided doses, adjusted according to serum and urinary levels.
1-2mmol/kg/day in divided doses, adjusted according to serum and urinary levels.
Prescribing Notes:
- Hyponatraemia may result from for example gastronintestinal loss, congential hypoplasia or chronic renal loss.
- If urinary sodium levels are less than 20mmol/l in neonates and less than 10mmol/l in older children, oral supplementation is required.
- Any unused reconstituted solution of Dioralyte should be discarded after 1 hour unless stored in a fridge when it may be kept for up to 24 hours.
History Notes
10/06/2020
Content migrated from LJF website.
In hot weather and holidays abroad
Birth - 11 months: 1-2mmol/kg/day in divided doses, adjusted according to serum and urinary levels.
1-5 years: 10-20mmol/day adjusted according to serum and urinary levels.
6-11 years: 30-60mmol/day adjusted according to serum and urinary levels.
12 years and over: 60mmol/day adjusted according to serum and urinary levels.
Birth - 11 months: 1-2mmol/kg/day in divided doses, adjusted according to serum and urinary levels.
1-5 years: 10-20mmol/day adjusted according to serum and urinary levels.
6-11 years: 30-60mmol/day adjusted according to serum and urinary levels.
12 years and over: 60mmol/day adjusted according to serum and urinary levels.
Birth - 11 months: 1-2mmol/kg/day in divided doses, adjusted according to serum and urinary levels.
1-5 years: 10-20mmol/day adjusted according to serum and urinary levels.
6-11 years: 30-60mmol/day adjusted according to serum and urinary levels.
12 years and over: 60mmol/day adjusted according to serum and urinary levels.
Birth - 11 months: 1-2mmol/kg/day in divided doses, adjusted according to serum and urinary levels.
1-5 years: 10-20mmol/day adjusted according to serum and urinary levels.
6-11 years: 30-60mmol/day adjusted according to serum and urinary levels.
12 years and over: 60mmol/day adjusted according to serum and urinary levels.
Birth - 11 months: 1-2mmol/kg/day in divided doses, adjusted according to serum and urinary levels.
1-5 years: 10-20mmol/day adjusted according to serum and urinary levels.
6-11 years: 30-60mmol/day adjusted according to serum and urinary levels.
12 years and over: 60mmol/day adjusted according to serum and urinary levels.
Prescribing Notes:
- Any unused reconstituted solution of Dioralyte should be discarded after 1 hour unless stored in a fridge when it may be kept for up to 24 hours.
History Notes
10/06/2020
Content migrated from LJF website.