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2017 ; 12
(ä): 1957-1965
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Hyponatremia in the elderly: challenges and solutions
#MMPMID29180859
Filippatos TD
; Makri A
; Elisaf MS
; Liamis G
Clin Interv Aging
2017[]; 12
(ä): 1957-1965
PMID29180859
show ga
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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