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Suffering from diabetes. Blood and urine test normal. Is there possible kidney trouble?

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General & Family Physician
Practicing since : 1978
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My mother is almost 94 years old. Her only health problem is controlled diabetes, which just came up when she
turned 90. Now her doctor says her sodium level of 130 is low, and he wants her to see a kidney specialist.
What could the problem be? Is there possible kidney trouble? All of her very recent blood work and urine sample have been good. Is there any food that she can eat that will help?
Posted Fri, 20 Jul 2012 in Diabetes
Answered by Dr. Pavan Kumar Gupta 3 hours later
Hello and thanks for the query.
A low sodium level in the blood may result from excess water or fluid in the body, diluting the normal amount of sodium so that the concentration appears low. This type of hyponatremia can be the result of chronic conditions such as kidney failure (when excess fluid cannot be efficiently excreted) and congestive heart failure, in which excess fluid accumulates in the body. SIADH (syndrome of inappropriate anti-diuretic hormone) is a disease whereby the body produces too much anti-diuretic hormone (ADH), resulting in retention of water in the body. Consuming excess water, for example during strenuous exercise, without adequate replacement of sodium, can also result in hyponatremia.

Hyponatremia can also result when sodium is lost from the body or when both sodium and fluid are lost from the body, for example, during prolonged sweating and severe vomiting or diarrhea.

Medical conditions that can sometimes be associated with hyponatremia are adrenal insufficiency, hypothyroidism, and cirrhosis of the liver.

Finally, a number of medications can lower blood sodium levels. Examples of these include diuretics, vasopressin, and the sulfonylurea drugs.

Mild chronic hyponatremia may not require treatment other than adjustments in diet, lifestyle, or medications. For severe or acute hyponatremia, treatment typically involves the intravenous administration of fluids and electrolytes. In this case medications are often needed that treat the underlying cause of the hyponatremia as well as medications to manage the accompanying symptoms.

I think your mother is suffering from mild chronic hyponatremia may be due to anti diabetic drugs or less dietary intake or may be hypothyroidism. I don't think she would be requiring any treatment as she seems to be in perfect health and doing her normal routine works without any symptoms of hyponatremia.
However she must be examined by a nephrologist to look for any medical cause behind her hyponatremia.
I hope to have answered your query however you may revert to me for any further query.
Best of luck

Above answer was peer-reviewed by
Follow-up: Suffering from diabetes. Blood and urine test normal. Is there possible kidney trouble? 2 hours later

Thank you so very much for your answer.
What about the sodium level of 130?
Is that okay? So, you think from what
I have told you that this is a treatable
problem, and shouldn't her doctor be
able to tell if the kidney is functioning
normally by way of the blood tests and
urine samples?

Thanks again,

Answered by Dr. Pavan Kumar Gupta 2 hours later
The normal range of sodium is between 135 to 145.
The levels of 130 is slightly lower.
The most important aspect is that your mother is absolutely healthy and there is no complaint as such.
If no medical cause is found for low sodium,then probably there is no need to do anything extra for the treatment.
The functioning of kidney can be determined by various blood tests and urine test
Above answer was peer-reviewed by
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