Disorders of sodium and water metabolism are common in hospitalized patients and sometimes found in outpatients also. Because of senile changes and chronic co-morbidities associated with elderly and impairment of salt, water metabolism occur. All physicians should be aware of the etiology, pathophysiology and clinical profile of hypo- natraemia. This study was conducted at a rural teaching hospital in Nandyal town of AndhraPradesh, wherein a total of 840 elderly sick patients admitted to the ICU were screened, of whom 302 patients (36%) were detected to have hyponatremia (< 135 mMol/L). The mean age of the patients was 72 yrs with a range of 60 yrs to 99 yrs. Of these patients 42% were males and 58% were females. Patients with CNS symptoms were treated with intravenous 3% saline infusion to raise there serum sodium levels by 0.5 mMol/L per hour to a maximum of 12 mMol/L increase in serum sodium per day. Patients who did not have any CNS symptoms were treated based on severity of their presenting illness with either Intravenous hypertonic saline or oral correction with salt supplementation. In our study, it was noted that people who died had associated morbidities like severe sepsis with septic shock, progressive malignancy, progressive renal failure, and progressive cerebrovascular disease
