Physiopathologica, epidemiologica, clinical and therapeutic aspects of exercise-associated hyponatriemia

Caterina Urso, Gregorio Caimi, Salvatore Brucculeri

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    Exercise-associated hyponatremia (EAH) is dilutional hyponatremia, a variantof inappropriate antidiuretic hormone secretion (SIADH), characterized by a plasmaconcentration of sodium lower than 135 mEq/L. The prevalence of EAH is common inendurance (<6 hours) and ultra-endurance events (>6 hours in duration), in which bothathletes and medical providers need to be aware of risk factors, symptom presentation, andmanagement. The development of EAH is a combination of excessive water intake,inadequate suppression of the secretion of the antidiuretic hormone (ADH) (due to nonosmotic stimuli), long race duration, and very high or very low ambient temperatures.Additional risk factors include female gender, slower race times, and use of nonsteroidalanti-inflammatory drugs. Signs and symptoms of EAH include nausea, vomiting,confusion, headache and seizures; it may result in severe clinical conditions associatedwith pulmonary and cerebral edema, respiratory failure and death. A rapid diagnosis andappropriate treatment with a hypertonic saline solution is essential in the severe form toensure a positive outcome.
    Original languageEnglish
    Pages (from-to)1258-1275
    Number of pages18
    JournalJournal of Clinical Medicine
    Publication statusPublished - 2014


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