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Hypovolemic hyponatremia (low fluid status, low sodium concentration) Renal causes: thiazide diuretic use, chronic kidney disease Extra-renal: GI loss, pancreatitis, burns Euvolemic hyponatremia ( normal fluid status, low sodium concentration) Hypothyroidism, medication (NSAIDs, sulfonylureas), glucocorticoid deficiency, Syndrome of Inappropriate antidiuretic hormone secretion (SIADH), often associated with small cell lung cancer Hypervolemic hyponatremia (high fluid status, low sodium concentration) Renal failure, cirrhosis, heart failure, nephrotic syndrome When do people begin to have symptoms