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Important differences occur in patients with acute versus chronic hyponatremia. Acute hyponatremia develops over 48 hours or less, and patients are subject to more severe cerebral edema than those with chronic hyponatremia, which develops over more than 48 hours. If the serum sodium decreases slowly, or if it is greater than 125 mEq/L, the patient may be symptomfree. If the serum sodium level drops below 115 mEq/L, cerebral edema and increased brain cell volume occur that could result in death. If it is left untreated, hyponatremia can lead to potassium, calcium, chloride, and bicarbonate electrolyte imbalances; shock; convulsions; coma; and death.

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