Hyponatraemia is present in 15–20% of non-selected emergency admissions to hospitals in the UK. It is associated with increased mortality and morbidity as well as increased duration of stay, independent of the cause for admission. Hyponatraemia is therefore common and important, driving the need for a rational but practical management strategy. This must encompass a stratified approach based on clinical presentation, balancing diagnostic uncertainty and the relative merits of different interventions to achieve the best outcome.
Keywords Hyponatraemia, SIAD, vasopressin, vasopressin receptor antagonist
Declaration of Interests Dr Ball is a member of an advisory board of Otsuka Pharmaceuticals.
