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Hew-Butler T, Rosner MH, Fowkes-Godek S, et al. Statement of the Third International Exercise-Associated Hyponatremia Consensus Development Conference, Carlsbad, California, 2015. Clin J Sport Med. 2015 Jul;25(4):303-20. doi: 10.1097/JSM.0000000000000221. PubMed PMID: 26102445.
Spasovski G, Vanholder R, Allolio B, et al; Hyponatraemia Guideline Development Group. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Eur J Endocrinol. 2014 Feb 25;170(3):G1-47. doi: 10.1530/EJE-13-1020. Print 2014 Mar. Erratum in: Eur J Endocrinol. 2014 Jul;171(1):X1. PubMed PMID: 24569125.
Verbalis JG, Goldsmith SR, Greenberg A, et al. Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med. 2013 Oct;126(10 Suppl 1):S1-42. doi: 10.1016/j.amjmed.2013.07.006. PubMed PMID: 24074529.
Physiologic BackgroundTop
The body of an average adult weighing 70 kg contains ~4200 mmol (~60 mmol/kg) of sodium. A total of 91% of the body sodium is in the extracellular fluid (ECF) and the remainder is the intracellular fluid (ICF).
Dietary sodium intake is 80 to 160 mmol/d. In individuals with a normal sodium balance, 95% of dietary sodium is filtered into the renal tubule, 4.5% with feces, and 0.5% through the skin. Less than 1% of sodium filtered into the renal tubule is excreted with urine, while the remaining sodium is reabsorbed.
