Cost and resource allocation issues in managing hyponatremia: the pharmacist's role.

Hyponatremia is associated with significant morbidity and mortality in a wide variety of patients with underlying disease states. Hospital-associated hyponatremia is a common occurrence, and all forms of hyponatremia are independently associated with heightened resource consumption during hospitalization as well as after discharge to both short-term and long-term care facilities. The chronic morbidities of hyponatremia, even when not severe, can have a significant impact on health care costs. Resolving hyponatremia during hospitalization decreases the risk of mortality conferred by the disorder. Patients at risk for hyponatremia may not receive adequate investigation into cause of hyponatremia; thus, increased awareness may result in better identification of patients at risk, and more aggressive monitoring in both the inpatient and outpatient settings may lead to appropriate intervention. In the management of hyponatremia, clinical pharmacists have a key role in identifying the source of the hyponatremia, carefully monitoring serum sodium concentration and symptoms of hyponatremia, and intervening with appropriate therapy including avoidance of interventions that may exacerbate hyponatremia.