Dysnatremias in cancer

Dysnatremias are common electrolyte abnormalities noted in a cancer patient, with hyponatremia being the most common. Hyponatremia has been linked to poor prognosis and prolonged hospital stays, poor performance status, and increased mortality. Although hypernatremia has not been as extensively studied in the cancer population as hyponatremia, it also has been associated with increased incidences of morbidity, mortality and prolonged hospital stays. The use of normal saline as a resuscitative measure, in the majority of our cancer patients who are admitted, can lead to hospital acquired hypernatremia, as seen in many reports, with half of the intensive care unit patients with sepsis can develop hypernatremia. With the cancer patients having increased co-morbidities because of their underlying treatments and malignancy, dysnatremia would pose a challenge where there is a delay in their cancer care. We will discuss in this chapter the etiologies and management of dysnatremias and the uniqueness of the abnormality in the cancer population.