Is drinking too much water likely to increase mortality due to hyponatremia? Doctor: These people should not drink unless they are thirsty.
Beware of hyponatremia if you drink too much water! Doctor: We need to look at 4 indicators first
Isn’t drinking more water necessarily good for your health? Nephrologist Wang Jieli posted a message on social media to remind that many patients are told to drink as much water as possible, but they may ignore the danger of “hyponatremia”. Since the symptoms of hyponatremia are non-specific and difficult to distinguish from other disease manifestations, patients may be misdiagnosed as a cold, which may even increase the patient’s overall mortality.
Dr. Wang Jieli pointed out that it is a professional recommendation for nephrologists to ask patients to drink more water. Before asking patients to increase their water intake, they must at least assess GFR (glomerular filtration rate), urine output, diet and lifestyle, Urine specific gravity or osmotic pressure (dipstick) or at least urine color.
The regulation of sodium and water not only affects the body’s water balance, but is also very important for blood volume and blood pressure control. Under normal circumstances, the sodium ion concentration in plasma is maintained within the range of 135-145mmol/L. If there is too much water and too little sodium , resulting in sodium ion concentration lower than the normal range, which is hyponatremia.
Hyponatremia increases mortality? The most common electrolyte abnormalities in the elderly
Dr. Wang Jieli explained that humans are terrestrial animals, and the design principle of the organism is based on the principle of “not drinking too much water.” Especially if there is a cause or constitution of hyponatremia, “drinking more water without any problem” will only cause Or aggravate the occurrence of hyponatremia, which may even require emergency treatment.
Hyponatremia is the most common electrolyte abnormality in the elderly. Dr. Wang Jieli reminds that the overall mortality rate of elderly people with hyponatremia will also increase. Although the causal relationship is relatively complicated, it is generally believed that hyponatremia itself promotes mortality. Increased pathogenesis turns a circle.
Do kidney dialysis patients have to drink more water? Is it safe to drink when you are thirsty?
“Doctors will only recommend (drink more water) when they are seeing patients seriously. In daily life, I will not just tell people to drink more water!” Dr. Wang Jieli said that whenever a kidney dialysis (dialysis) patient asks When it comes to how much water you can drink in a day, the standard answer is actually “drink when you are thirsty, but don’t drink when you are not thirsty” to prevent patients from drinking too much water and increasing the risk of hyponatremia.
Dr. Wang Jieli explained that if kidney dialysis patients are not properly reminded that they do not need to drink more water, it is easy for patients to think that they must take in extra water of “urine output + 600 to 800” and not drink it. This is actually a misconception. The amount of water that is estimated based on urine output is the “maximum daily allowable amount” rather than the “minimum necessary amount”. For dialysis patients, if they are not thirsty at all, it will not be a problem if they do not drink water for a whole day.
Dr. Wang Jieli emphasized that many people are influenced by popular culture and believe that “it’s okay to drink more water and it’s okay to drink more water.” However, from a doctor’s perspective, the suggestion of “drinking more water” must be taken with the rigor of prescribing medical advice, especially if the patient is ill. Patients take the doctor’s words as an edict and should avoid metabolic burden caused by excessive drinking of water before fully evaluating kidney function and the risk of hyponatremia.
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