Utility and Limitations of the Traditional Diagnostic Approach to Hyponatremia: A Diagnostic Study

Abstract Background The differential diagnosis of hyponatremia is often challenging because of its association with multiple underlying pathophysiological mechanisms, diseases, and treatment options. Several algorithms are available to guide the diagnostic approach to hyponatremia, but their diagnostic and clinical utility has never been evaluated. We aimed to assess in detail the diagnostic utility as well as the limitations of the existing approaches to hyponatremia. Methods Each of the 121 consecutive subjects presenting with hyponatremia (serum sodium