The sodium level in the blood, if too high or too low, can lead to neurologic manifestations such as clumsiness, confusion, and falls. The kidneys maintain sodium balance in the blood by managing how much water it either holds on to or gets rid of. There are some medications which can alter the ability of the kidney to maintain adequate water balance, and lead to either not enough water being kept in the body (so the sodium level in the blood is concentrated and therefore lead to high sodium levels,) or too much water being kept in the body (so the sodium level in the blood is diluted, and therefore lead to low sodium levels.) Some systemic disorders such as chronic heart failure or cirrhosis can lead to altered regulation of water balance by the kidney as well. Evaluation by the nephrologist can lead to understanding the cause of the problem leading to too low or too high a sodium level, and a plan for normalization of these levels.
