Hyponatraemia - a simulation-based tutorial
Hello, and thank you for visiting this page!
Hyponatraemia is an important but difficult topic that I had to keep revisiting throughout medical school. At one point, I finally felt like it fully clicked for me, and this is an attempt to share my understanding.
The following is a step-by-step tutorial which uses interactive simulations to help you intuitively understand how the body regulates osmolality and volume, and how exactly hyponatraemia can occur when it goes wrong. By the end, we will have gradually built a hyponatraemia algorithm from the ground up, which you will understand much more deeply than if you had just looked up a flow chart.
A few notes before you begin:
- Due to the interactive animations, I strongly recommend going through this tutorial on a computer-based web browser, using a mouse.
- The aim is to improve your intuitive understanding of hyponatraemia and thus we won't present an algorithm at the very beginning. Instead we'll very gradually get to it. If you want to skip straight to the final algorithm and a summary of all the key points, click here
- It could take up to roughly an hour to get through this tutorial if these concepts are completely new
- This tutorial only covers true hyponatraemia (when serum osmolality is low) and not artefactual hyponatraemia, which is much less common.
- This tutorial covers all main causes of true hyponatraemia, but not reset osmostat or cerebral salt-wasting
- We will not cover the management of hyponatraemia