Can hyperglycemia cause pseudohyponatremia?
[1] The finding of pseudohyponatremia is an artifact that results from the way a blood sample is processed for serum sodium measurement. Some sources cite the presence of osmotically-active solutes, such as mannitol or hyperglycemia, as an additional etiology of pseudohyponatremia.
How do you detect pseudohyponatremia?
Pseudohyponatremia is an artefact; measured serum sodium is reduced but actual plasma sodium is normal. The condition can only arise if the serum lipid or protein concentration is markedly increased and plasma sodium is measured using either indirect ISE or flame photometer.
Why is there pseudohyponatremia in DKA?
Diabetic ketoacidosis (DKA) causes a hyperosmolar state driven by the osmotic force of hyperglycemia in the intravascular space. Dilutional hyponatremia is common due to water driven into the intravascular space from inside cells. On rare occasions, hypernatremia is found in DKA.
How does hyperglycemia affect hyponatremia?
Hyperglycemia causes hyperosmolality, and the water moves from intracellular space to extracellular space, which in turn produces a dilutional decrease in serum sodium level. Therefore, hyperglycemic patients are mostly mildly hyponatremic.
How does Hyperproteinemia cause pseudohyponatremia?
In states of hyperproteinemia or hyperlipidemia, there is an increased mass of the nonaqueous components of serum and a concomitant decrease in the proportion of serum composed of water. Thus, pseudohyponatremia results because the flame photometry method measures sodium concentration in whole plasma.
How does hyperproteinemia cause pseudohyponatremia?
How does hyperlipidemia and hyperproteinemia cause pseudohyponatremia?
What are the signs and symptoms of hyperglycemia and hypoglycemia?
Symptom comparison chart
| Blood sugar level | Symptoms |
|---|---|
| Hypoglycemia | hunger irritability trouble concentrating fatigue sweating confusion fast heartbeat shaking headache |
| Hyperglycemia | extreme thirst dry mouth weakness headache frequent urination blurry vision nausea confusion shortness of breath |
Can leukocytosis cause pseudohyponatremia?
Reverse pseudohyperkalemia is defined as falsely elevated plasma potassium levels that concurrently are higher than that found in serum [36]. It occurs in massive leukocytosis when heparin is used as the anticoagulant in the plasma tubes, possibly due to heparin-induced cell lysis [37].
How does hyperlipidemia and Hyperproteinemia cause pseudohyponatremia?
Does hyperglycemia cause hyperkalemia?
Hyperglycemia can induce hyperkalemia in diabetic patients with insulin deficiency [1,2]. It is thus recommended to monitor potassium concentrations in diabetic patients.