Water, electrolytes, and acid-base alterations in human immunodeficiency virus infected patients

Table 1 Causes of hypotonic hyponatremia in human immunodeficiency virus infected patients

Hyponatremia with normal ECF

SIADH: Lungs or central nervous system infection or neoplasm

Hypothyroidism: Low T3 syndrome, pituitary infections, thyroiditis and miconazole

Glucocorticoid deficiency: Glucocorticoid axis damaged

Hyponatremia with low ECF (volume depletion)

Digestive losses: vomiting, diarrhea

Renal losses: CSW, interstitial nephritis, cortisol resistance and adrenal insufficiency

Hyponatremia with high ECF (edematous states)

Non-renal causes: cirrhosis, heart failure

Renal causes: acute tubular necrosis, intra-tubular obstruction, interstitial nephritis, nephrocalcinosis, hemolytic-uremic syndrome, collapsing focal and segmental glomerulosclerosis

Hyponatremia secondary to drugs

Renal insufficiency

Interstitial nephritis

Impair maximal urinary dilution capability by direct tubular effect

Cortisol deficiency

SIADH effect

ECF: Extracellular fluid; SIADH: Syndrome of inappropriate antidiuretic hormone release; CSW: Cerebral salt wasting.