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Marquina et al. J Cancer Metastasis Treat 2020;6:6 Journal of Cancer
DOI: 10.20517/2394-4722.2019.39 Metastasis and Treatment

Review Open Access

The management of hyponatremia in cancer
patients: a practical view in Spain

Gloria Marquina , Emilia Gomez-Hoyos , Isabelle Runkle 3
2
1
1 Department of Medical Oncology, Hospital Clínico San Carlos, Madrid 28040, Spain.
2 Department of Endocrinology and Nutrition, Hospital Clínico Universitario de Valladolid, Valladolid 47003, Spain.
3 Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, Madrid 28040, Spain.
Correspondence to: Dr. Gloria Marquina, Department of Medical Oncology, Hospital Clínico San Carlos, Madrid 28040, Spain.
E-mail:gloriamarquina@gmail.com
How to cite this article: Marquina G, Gomez-Hoyos E, Runkle I. The management of hyponatremia in cancer patients: a practical
view in Spain. J Cancer Metastasis Treat 2020;6:6. http://dx.doi.org/10.20517/2394-4722.2019.39

Received: 13 Oct 2019 First Decision: 6 Jan 2020 Revised: 28 Jan 2020 Accepted: 18 Feb 2020 Published: 11 Mar 2020

Science Editor: William P. Schiemann Copy Editor: Jing-Wen Zhang Production Editor: Jing Yu

Abstract

Hyponatremia is a common disorder among cancer patients and is associated with a poor prognosis in several
malignancies. It is classified by volemic status into hypovolemic, euvolemic, and hypervolemic hyponatremia.
Clinical history, physical examination, and blood and urine tests are important for a correct classification and
diagnosis of hyponatremia, to assure correct management. Treatment of hyponatremia in cancer patients depends
on the etiology of hyponatremia, as well as on the chosen therapy for the tumor. Supportive care is also a factor to
be taken into account.

Keywords: Hyponatremia, sodium, cancer, syndrome of inappropriate antidiuretic hormone secretion, antidiuretic
hormone, supportive care

INTRODUCTION
[1]
Hyponatremia is the most frequent electrolyte disorder found in cancer patients . It is defined as a
serum sodium level (SNa) of less than 135 mmol/L. Hyponatremia is generally classified into mild
(130-135 mmol/L), moderate (120-129 mmol/L), and severe (< 120 mmol/L) according to the SNa, and
is usually correlated with its symptoms , However, the velocity of descent should also be taken into
[2]
account, as severe, acute hyponatremia is also defined as a drop in sodium levels of more than 10 mmol/L
in 48 h. The precise prevalence of hyponatremia in patients with cancer has yet to be determined. The

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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