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<p>Hyponatraemia is one of the most common electrolyte abnormalities encountered in clinical practice, seen in up to 30% of hospitalised children. A key part of the evaluation of hyponatraemia concerns the assessment of volume status. Whereas hypovolaemia indicates a deficit in salt, euvolaemic hyponatraemia is most commonly associated with excess water. An important yet often forgotten differential diagnosis in chronic euvolaemic hyponatraemia is a reset osmostat, where patients regulate their plasma osmolality around a set point below the normal range. Here we present a case of an adolescent with chronic hyponatraemia and how we arrived at a diagnosis of a reset osmostat through simple diagnostic tests.</p>

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Chronic hyponatraemia with a reset osmostat: when abnormal is normal

  • 期刊论文

  • 发表日期：

    2026年6月30日

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  • Hannah Butaye,
  • Lotte Hoskens,
  • Detlef Bockenhauer

摘要

Hyponatraemia is one of the most common electrolyte abnormalities encountered in clinical practice, seen in up to 30% of hospitalised children. A key part of the evaluation of hyponatraemia concerns the assessment of volume status. Whereas hypovolaemia indicates a deficit in salt, euvolaemic hyponatraemia is most commonly associated with excess water. An important yet often forgotten differential diagnosis in chronic euvolaemic hyponatraemia is a reset osmostat, where patients regulate their plasma osmolality around a set point below the normal range. Here we present a case of an adolescent with chronic hyponatraemia and how we arrived at a diagnosis of a reset osmostat through simple diagnostic tests.