Hyponatremia: Special Considerations in Older Patients

Journal of Clinical Medicine

Roy L. Soiza¹  Phyo K. Myint¹  Jennifer M. Clarke²  Kirsten Cumming²  Karen M. Wood² 

[1] Department of Medicine for the Elderly, NHS Grampian, c/o Wards 303/4, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN, UK;School of Medicine & Dentistry, University of Aberdeen, Aberdeen AB25 2ZD, UK;

关键词: aging;    arginine vasopressin;    geriatrics;    hyponatremia;    old;    salt;    sodium;   

DOI  :  10.3390/jcm3030944

来源: DOAJ

【 摘 要 】

Hyponatremia is especially common in older people. Recent evidence highlights that even mild, chronic hyponatremia can lead to cognitive impairment, falls and fractures, the latter being in part due to bone demineralization and reduced bone quality. Hyponatremia is therefore of special significance in frail older people. Management of hyponatremia in elderly individuals is particularly challenging. The underlying cause is often multi-factorial, a clear history may be difficult to obtain and clinical examination is unreliable. Established treatment modalities are often ineffective and carry considerable risks, especially if the diagnosis of underlying causes is incorrect. Nevertheless, there is some evidence that correction of hyponatremia can improve cognitive performance and postural balance, potentially minimizing the risk of falls and fractures. Oral vasopressin receptor antagonists (vaptans) are a promising innovation, but evidence of their safety and effect on important clinical outcomes in frail elderly individuals is limited.

【 授权许可】

Unknown