Hyponatremia in hospital practice: an integrative review on clinical impact and relevance for the multidisciplinary team

Abstract

Objective: To critically synthesize recent evidence on hyponatremia in the hospital setting, considering pathophysiological foundations, clinical-laboratory criteria, correction strategies, including hypertonic salineand clinical, functional, and care-related repercussions from a multidisciplinary perspective. Methods: Integrative review with an expanded search across nine databases (2021–2026), comprising an analytical core (clinical trial, observational studies, and systematic reviews/meta-analyses) and contextual support (guidelines and narrative/practical reviews) integrated into a critical interpretation of the findings. After screening 1,482 records and evaluating 75 full texts, 12 studies composed the final synthesis. Results: In severe hyponatremia, controlled rapid correction was associated with better clinical outcomes when conducted with strict monitoring. Insymptomatic cases, hypertonic saline boluses demonstrated greater operational efficiency than continuous infusions. Mild/moderate hyponatremia showed a consistent association with postural instability and falls, although effects on fractures remain uncertain. Additional findings included prolonged hospital stay, increased risk of readmissions, and relevant organizational implications. Final considerations: Hospital management of hyponatremia requires clear parametric targets, serial monitoring, and multidisciplinary integration. Therapeutic and functional gaps persist, justifying further investigations.