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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Am+Soc+Nephrol
2016 ; 27
(3
): 766-80
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Chronic Hyponatremia Causes Neurologic and Psychologic Impairments
#MMPMID26376860
Fujisawa H
; Sugimura Y
; Takagi H
; Mizoguchi H
; Takeuchi H
; Izumida H
; Nakashima K
; Ochiai H
; Takeuchi S
; Kiyota A
; Fukumoto K
; Iwama S
; Takagishi Y
; Hayashi Y
; Arima H
; Komatsu Y
; Murata Y
; Oiso Y
J Am Soc Nephrol
2016[Mar]; 27
(3
): 766-80
PMID26376860
show ga
Hyponatremia is the most common clinical electrolyte disorder. Once thought to be
asymptomatic in response to adaptation by the brain, recent evidence suggests
that chronic hyponatremia may be linked to attention deficits, gait disturbances,
risk of falls, and cognitive impairments. Such neurologic defects are associated
with a reduction in quality of life and may be a significant cause of mortality.
However, because underlying diseases such as adrenal insufficiency, heart
failure, liver cirrhosis, and cancer may also affect brain function, the
contribution of hyponatremia alone to neurologic manifestations and the
underlying mechanisms remain unclear. Using a syndrome of inappropriate secretion
of antidiuretic hormone rat model, we show here that sustained reduction of serum
sodium ion concentration induced gait disturbances; facilitated the extinction of
a contextual fear memory; caused cognitive impairment in a novel object
recognition test; and impaired long-term potentiation at hippocampal CA3-CA1
synapses. In vivo microdialysis revealed an elevated extracellular glutamate
concentration in the hippocampus of chronically hyponatremic rats. A sustained
low extracellular sodium ion concentration also decreased glutamate uptake by
primary astrocyte cultures, suggesting an underlying mechanism of impaired
long-term potentiation. Furthermore, gait and memory performances of corrected
hyponatremic rats were equivalent to those of control rats. Thus, these results
suggest chronic hyponatremia in humans may cause gait disturbance and cognitive
impairment, but these abnormalities are reversible and careful correction of this
condition may improve quality of life and reduce mortality.
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