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Hyponatremia in the elderly: challenges and solutions

Decreased serum sodium concentration is a rather frequent electrolyte disorder in the elderly population because of the presence of factors contributing to increased antidiuretic hormone, the frequent prescription of drugs associated with hyponatremia and also because of other mechanisms such as the...

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Autores principales: Filippatos, Theodosios D, Makri, Andromachi, Elisaf, Moses S, Liamis, George
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694198/
https://www.ncbi.nlm.nih.gov/pubmed/29180859
http://dx.doi.org/10.2147/CIA.S138535
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author Filippatos, Theodosios D
Makri, Andromachi
Elisaf, Moses S
Liamis, George
author_facet Filippatos, Theodosios D
Makri, Andromachi
Elisaf, Moses S
Liamis, George
author_sort Filippatos, Theodosios D
collection PubMed
description Decreased serum sodium concentration is a rather frequent electrolyte disorder in the elderly population because of the presence of factors contributing to increased antidiuretic hormone, the frequent prescription of drugs associated with hyponatremia and also because of other mechanisms such as the “tea and toast” syndrome. The aim of this review is to present certain challenges in the evaluation and treatment of hyponatremia in the elderly population and provide practical solutions. Hyponatremia in elderly subjects is mainly caused by drugs (more frequently thiazides and antidepressants), the syndrome of inappropriate antidiuretic hormone secretion (SIAD) or endocrinopathies; however, hyponatremia is multifactorial in a significant proportion of patients. Special attention is needed in the elderly population to exclude endocrinopathies as a cause of hyponatremia before establishing the diagnosis of SIAD, which then requires a stepped diagnostic approach to reveal its underlying cause. The treatment of hyponatremia depends on the type of hyponatremia. Special attention is also needed to correct serum sodium levels at the appropriate rate, especially in chronic hyponatremia, in order to avoid the osmotic demyelination syndrome. In conclusion, both the evaluation and the treatment of hyponatremia pose many challenges in the elderly population.
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spelling pubmed-56941982017-11-27 Hyponatremia in the elderly: challenges and solutions Filippatos, Theodosios D Makri, Andromachi Elisaf, Moses S Liamis, George Clin Interv Aging Review Decreased serum sodium concentration is a rather frequent electrolyte disorder in the elderly population because of the presence of factors contributing to increased antidiuretic hormone, the frequent prescription of drugs associated with hyponatremia and also because of other mechanisms such as the “tea and toast” syndrome. The aim of this review is to present certain challenges in the evaluation and treatment of hyponatremia in the elderly population and provide practical solutions. Hyponatremia in elderly subjects is mainly caused by drugs (more frequently thiazides and antidepressants), the syndrome of inappropriate antidiuretic hormone secretion (SIAD) or endocrinopathies; however, hyponatremia is multifactorial in a significant proportion of patients. Special attention is needed in the elderly population to exclude endocrinopathies as a cause of hyponatremia before establishing the diagnosis of SIAD, which then requires a stepped diagnostic approach to reveal its underlying cause. The treatment of hyponatremia depends on the type of hyponatremia. Special attention is also needed to correct serum sodium levels at the appropriate rate, especially in chronic hyponatremia, in order to avoid the osmotic demyelination syndrome. In conclusion, both the evaluation and the treatment of hyponatremia pose many challenges in the elderly population. Dove Medical Press 2017-11-14 /pmc/articles/PMC5694198/ /pubmed/29180859 http://dx.doi.org/10.2147/CIA.S138535 Text en © 2017 Filippatos et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Filippatos, Theodosios D
Makri, Andromachi
Elisaf, Moses S
Liamis, George
Hyponatremia in the elderly: challenges and solutions
title Hyponatremia in the elderly: challenges and solutions
title_full Hyponatremia in the elderly: challenges and solutions
title_fullStr Hyponatremia in the elderly: challenges and solutions
title_full_unstemmed Hyponatremia in the elderly: challenges and solutions
title_short Hyponatremia in the elderly: challenges and solutions
title_sort hyponatremia in the elderly: challenges and solutions
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694198/
https://www.ncbi.nlm.nih.gov/pubmed/29180859
http://dx.doi.org/10.2147/CIA.S138535
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