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Physiopathological, Epidemiological, Clinical and Therapeutic Aspects of
Exercise-Associated Hyponatremia
#MMPMID26237602
Urso C
; Brucculeri S
; Caimi G
J Clin Med
2014[Nov]; 3
(4
): 1258-75
PMID26237602
show ga
Exercise-associated hyponatremia (EAH) is dilutional hyponatremia, a variant of
inappropriate antidiuretic hormone secretion (SIADH), characterized by a plasma
concentration of sodium lower than 135 mEq/L. The prevalence of EAH is common in
endurance (<6 hours) and ultra-endurance events (>6 hours in duration), in which
both athletes and medical providers need to be aware of risk factors, symptom
presentation, and management. The development of EAH is a combination of
excessive water intake, inadequate suppression of the secretion of the
antidiuretic hormone (ADH) (due to non osmotic stimuli), long race duration, and
very high or very low ambient temperatures. Additional risk factors include
female gender, slower race times, and use of nonsteroidal anti-inflammatory
drugs. Signs and symptoms of EAH include nausea, vomiting, confusion, headache
and seizures; it may result in severe clinical conditions associated with
pulmonary and cerebral edema, respiratory failure and death. A rapid diagnosis
and appropriate treatment with a hypertonic saline solution is essential in the
severe form to ensure a positive outcome.
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