Why does hyponatremia sometimes occur in patients with nephrotic syndrome, despite total body sodium often being elevated?

💡 Explanation

Hyponatremia in nephrotic syndrome occurs because the loss of protein in urine leads to decreased plasma oncotic pressure; therefore, fluid shifts into the interstitial space, stimulating ADH release and causing water retention that dilutes sodium, rather than a direct sodium excretion or imbalance of aldosterone.

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