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Physiopathological, Epidemiological, Clinical and Therapeutic Aspects of Exercise-Associated Hyponatremia

Department of Internal Medicine, University Medical Centre, 90127 Palermo, Italy
Author to whom correspondence should be addressed.
J. Clin. Med. 2014, 3(4), 1258-1275;
Received: 21 August 2014 / Revised: 24 October 2014 / Accepted: 24 October 2014 / Published: 12 November 2014
(This article belongs to the Special Issue Hyponatremia: Advances in Diagnosis and Management)
Exercise-associated hyponatremia (EAH) is dilutional hyponatremia, a variant of inappropriate antidiuretic hormone secretion (SIADH), characterized by a plasma concentration of sodium lower than 135 mEq/L. The prevalence of EAH is common in endurance (<6 hours) and ultra-endurance events (>6 hours in duration), in which both athletes and medical providers need to be aware of risk factors, symptom presentation, and management. The development of EAH is a combination of excessive water intake, inadequate suppression of the secretion of the antidiuretic hormone (ADH) (due to non osmotic stimuli), long race duration, and very high or very low ambient temperatures. Additional risk factors include female gender, slower race times, and use of nonsteroidal anti-inflammatory drugs. Signs and symptoms of EAH include nausea, vomiting, confusion, headache and seizures; it may result in severe clinical conditions associated with pulmonary and cerebral edema, respiratory failure and death. A rapid diagnosis and appropriate treatment with a hypertonic saline solution is essential in the severe form to ensure a positive outcome. View Full-Text
Keywords: hyponatremia; exercise; SIADH; hypertonic saline hyponatremia; exercise; SIADH; hypertonic saline
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Urso, C.; Brucculeri, S.; Caimi, G. Physiopathological, Epidemiological, Clinical and Therapeutic Aspects of Exercise-Associated Hyponatremia. J. Clin. Med. 2014, 3, 1258-1275.

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