Incidence and Etiology of Hyponatremia in Hospitalized Patients at a Tertiary Care Center: A Cross-sectional Observational Study

decline rather than the absolute value.Early manifestations include anorexia, nausea, and vomiting, which may progress to irritability, headache, confusion, seizures, and coma.Because symptoms are nonspecific, diagnosis can be challenging.Appropriate diagnosis and treatment reduce symptom burden, length of hospital stay, and mortality, while improving care of comorbid illnesses.Hyponatremia is commonly graded as mild (130-135 mEq/L), moderate (125-129 mEq/L), or severe (<125 mEq/L). 7nderstanding its etiology and risk factors is crucial to preventing complications and enhancing patient outcomes. IntroductIonHyponatremia is the most frequently observed electrolyte abnormality among hospitalized patients and is associated with higher mortality.Compared to individuals with normal sodium levels, hyponatremic patients have significantly greater risk of death, 1 with reported mortality varying widely between 1.5 and 60-fold. 2 By definition, hyponatremia occurs when serum sodium concentration falls below 135 mEq/L. 3Elderly patients are especially vulnerable due to age-related decline in water and electrolyte regulation, coupled with dietary, pharmacological, and lifestyle factors. 4lthough not a disease by itself, hyponatremia often reflects underlying life-threatening conditions.Its etiology varies across populations. 5In India and other developing nations, tuberculosis (TB) remains a notable contributor.Hyponatremia in TB can result from adrenal insufficiency (secondary to adrenal involvement), hypothalamic or pituitary invasion, tubercular meningitis, or pulmonary disease-related syndrome of inappropriate antidiuretic hormone (SIADH). 6imely recognition and intervention are essential for improving neurological recovery and minimizing hospitalization. 3atients with sodium concentrations above 130 mEq/L often remain asymptomatic, while lower levels may trigger clinical features.Presentations vary depending on the rate of sodium 1-