Hyponatremia in the elderly: challenges and solutions

Theodosios D Filippatos, Andromachi Makri, Moses S Elisaf, George Liamis Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece Abstract: Decreased serum sodium concentration is a rather frequent electrolyte disorder in the elderly population because of the p...

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Autores principales:	Filippatos TD, Makri A, Elisaf MS, Liamis G
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	hyponatremia elderly age antidiuretic hormone drugs pituitary Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/7c009e84100e4eacad6da3716fe94209
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spelling	oai:doaj.org-article:7c009e84100e4eacad6da3716fe942092021-12-02T09:02:37ZHyponatremia in the elderly: challenges and solutions1178-1998https://doaj.org/article/7c009e84100e4eacad6da3716fe942092017-11-01T00:00:00Zhttps://www.dovepress.com/hyponatremia-in-the-elderly-challenges-and-solutions-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Theodosios D Filippatos, Andromachi Makri, Moses S Elisaf, George Liamis Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece Abstract: 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. Keywords: sodium, prognosis, hypopituitarism, elderly, pituitaryFilippatos TDMakri AElisaf MSLiamis GDove Medical Pressarticlehyponatremiaelderlyageantidiuretic hormonedrugspituitaryGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 1957-1965 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	hyponatremia elderly age antidiuretic hormone drugs pituitary Geriatrics RC952-954.6
spellingShingle	hyponatremia elderly age antidiuretic hormone drugs pituitary Geriatrics RC952-954.6 Filippatos TD Makri A Elisaf MS Liamis G Hyponatremia in the elderly: challenges and solutions
description	Theodosios D Filippatos, Andromachi Makri, Moses S Elisaf, George Liamis Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece Abstract: 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. Keywords: sodium, prognosis, hypopituitarism, elderly, pituitary
format	article
author	Filippatos TD Makri A Elisaf MS Liamis G
author_facet	Filippatos TD Makri A Elisaf MS Liamis G
author_sort	Filippatos TD
title	Hyponatremia in the elderly: challenges and solutions
title_short	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_sort	hyponatremia in the elderly: challenges and solutions
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/7c009e84100e4eacad6da3716fe94209
work_keys_str_mv	AT filippatostd hyponatremiaintheelderlychallengesandsolutions AT makria hyponatremiaintheelderlychallengesandsolutions AT elisafms hyponatremiaintheelderlychallengesandsolutions AT liamisg hyponatremiaintheelderlychallengesandsolutions
_version_	1718398253245923328

Hyponatremia in the elderly: challenges and solutions

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