In hypovolemic hyponatremia with urine less than 10 mEq/L, which is a likely cause?

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Multiple Choice

In hypovolemic hyponatremia with urine less than 10 mEq/L, which is a likely cause?

When hyponatremia occurs with reduced extracellular fluid volume, the kidneys respond by conserving sodium to restore volume. This leads to a very low urine sodium concentration (often <10 mEq/L). That pattern points to volume depletion from non-renal Na loss—essentially dehydration—where the body activates RAAS and ADH to hold onto Na+ and water. Among the options, dehydration fits best because it represents true hypovolemia with robust renal Na+ retention, producing the very low urine sodium. Renal failure would disrupt Na+ reabsorption and typically show a higher urine Na; liver cirrhosis tends to cause hypervolemic, not hypovolemic, hyponatremia; diarrhea also causes GI Na+ losses but the pronounced low urine Na most closely aligns with dehydration in this context.

When hyponatremia occurs with reduced extracellular fluid volume, the kidneys respond by conserving sodium to restore volume. This leads to a very low urine sodium concentration (often <10 mEq/L). That pattern points to volume depletion from non-renal Na loss—essentially dehydration—where the body activates RAAS and ADH to hold onto Na+ and water. Among the options, dehydration fits best because it represents true hypovolemia with robust renal Na+ retention, producing the very low urine sodium. Renal failure would disrupt Na+ reabsorption and typically show a higher urine Na; liver cirrhosis tends to cause hypervolemic, not hypovolemic, hyponatremia; diarrhea also causes GI Na+ losses but the pronounced low urine Na most closely aligns with dehydration in this context.

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