Prevalence and Description of Hyponatremia in a Swiss Tertiary Care Hospital: An Observational Retrospective Study

Lu, Henri; Vollenweider, Péter; Kissling, Sébastien; Marques‐Vidal, Pedro

doi:10.3389/fmed.2020.00512

Cited by 16 publications

(13 citation statements)

References 28 publications

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“…Hyponatremia (serum sodium levels <135 mmol/L) is the most common fluid and electrolyte imbalance in hospitalized patients [1]. It is more frequent among geriatric patients, with an estimated prevalence in hospitalized patients up to 32.5% [1]. The presence of hyponatremia in older patients is associated with impaired cognition, delirium, and a higher incidence of falls and fractures [2].…”

Section: Introductionmentioning

confidence: 99%

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Mirtazapine Risk of Hyponatremia and Syndrome of Inappropriate Antidiuretic Hormone Secretion in Adult and Elderly Patients: A Systematic Review

Moscona-Nissan¹,

López-Hernández²,

González-Morales³

2021

Cureus

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Hyponatremia is the most common fluid and electrolyte imbalance in hospitalized patients. Among hyponatremia causes, syndrome of inappropriate antidiuretic hormone secretion is a condition characterized by excessive release of antidiuretic hormone from the pituitary gland or nonpituitary sources. One of the most common drugs associated with hyponatremia is selective serotonin reuptake inhibitors, especially in elderly patients. Therefore, distinct therapeutic alternatives are essential for patients having risk factors for hyponatremia or syndrome of inappropriate antidiuretic hormone secretion development.The present article aims to review the available literature evaluating mirtazapine-induced hyponatremia or syndrome of inappropriate antidiuretic hormone secretion in adult or elderly patients in order to determine the incidence of these adverse effects and analyze the existence of any correlation between the administered dose of mirtazapine and serum sodium levels. A systematic search was conducted, using key terms from the research topic, their synonyms, and Boolean/logic operators. From this evidence pool, inclusion and exclusion criteria were applied. We abstracted population characteristics and clinical endpoints. Relevant data from selected studies was abstracted and subject to statistical analysis.A total sample size of 30,851 patients treated with mirtazapine was included. Mirtazapine-induced hyponatremia incidence was 3.26% (95% CI 3.06-3.45%), with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) the most probable underlying cause. Among case series and case reports evaluated (n=7), hyponatremia and SIADH were more frequent in female patients (71.4%) and the most frequent clinical manifestations included confusion (57%), somnolence (42%), and altered speech (28%). Mean serum sodium levels were (117 mEq/L, ranging from 113-130 mEq/L). The average time lapse between mirtazapine administration and clinical findings was 34 days. The Spearman's rank correlation coefficient between mirtazapine dosage and serum sodium levels was -0.3181 with a p-value >0.05.In conclusion, mirtazapine presents a moderate risk of hyponatremia and should be considered as an alternative therapy in patients requiring antidepressants with risk factors for this preventable adverse effect.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mirtazapine Risk of Hyponatremia and Syndrome of Inappropriate Antidiuretic Hormone Secretion in Adult and Elderly Patients: A Systematic Review

Moscona-Nissan¹,

López-Hernández²,

González-Morales³

2021

Cureus

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“…However, there are conflicting results regarding the association between gender and the prevalence of hyponatremia. For instance, unlike the Swiss study, hyponatremia was higher in females in the US study [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 71%

“…The association between hyponatremia and patient characteristics such as age and gender has been investigated thoroughly. The results have shown that the prevalence of hyponatremia increases with age [8][9][10]. However, there are conflicting results regarding the association between gender and the prevalence of hyponatremia.…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Chart Review: The Prevalence of Hyponatremia Among Elderly Inpatients in a Tertiary Care Centre in Saudi Arabia

Jastaniah¹,

Sagim²,

Sanyour³

et al. 2022

Cureus

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Introduction: Hyponatremia is commonly seen in inpatient care; however, the availability of data regarding the prevalence of hyponatremia in the elderly in Jeddah, Saudi Arabia is insufficient.Objectives: The objective of this study is to estimate the prevalence of hyponatremia in a sample of older inpatients.Materials and Methods: A retrospective chart review conducted in a tertiary care hospital, Jeddah, Saudi Arabia included all patients 60 years and older who were admitted to the internal medicine department between January 2017 and November 2020. Patients with hyponatremia were identified by looking through the hospital's laboratory database of inpatients. Patients' demographics, serum sodium level, medication history, and disease history were recorded and those with pseudohyponatremia were excluded.Results: During the study period, 322 out of a total of 2,893 elderly patients admitted to the internal medicine department were diagnosed with hyponatremia (11.1%). Of these patients, 183 (56.8%) were female and 139 (43.2%) were male. Hyponatremia was more prevalent in patients with cardiovascular diseases (84.2%), followed by endocrine diseases (73.3%). The most prescribed medications for the studied hyponatremic patients were proton pump inhibitors (38.8%), diuretics (29.8%), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (22.4%), all of which are commonly known to be associated with hyponatremia.Conclusions: Hyponatremia has severe consequences if left untreated. Therefore, estimating the prevalence of this condition in the older population will direct more clinical attention to evaluate the serum sodium level on a regular basis. It is recommended that future studies focus on finding an association between hyponatremia and older patients with multi-drug usage as well as identifying the causes of hyponatremia.

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“…Hyponatremia is a common electrolyte among hospitalized patients that poses diagnostic and therapeutic challenges. A recent retrospective study associated persistent hyponatremia with increased length of stay, readmissions, and mortality [ 1 ]. Accurate diagnosis of the etiology of hyponatremia is dependent on an understanding of water homeostasis [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Severe hyponatremia due to surreptitious water intoxication in a hospitalized patient

2022

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Hyponatremia is a common electrolyte abnormality among hospitalized patients and often present as first sign of other underlying medical conditions. Severe hyponatremia can be life threatening and requires prompt diagnosis and treatment. We present a case of refractory hyponatremia that was a diagnostic challenge requiring a prolonged hospitalization. Diagnosis of primary polydipsia was ultimately suspected due to improbable 24-h urine studies and confirmed through complete removal of free water access in the form of disconnecting the bathroom faucet in the patient’s hospital room. Diagnosis and management of primary polydipsia is further discussed.

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Prevalence and Description of Hyponatremia in a Swiss Tertiary Care Hospital: An Observational Retrospective Study

Cited by 16 publications

References 28 publications

Mirtazapine Risk of Hyponatremia and Syndrome of Inappropriate Antidiuretic Hormone Secretion in Adult and Elderly Patients: A Systematic Review

Mirtazapine Risk of Hyponatremia and Syndrome of Inappropriate Antidiuretic Hormone Secretion in Adult and Elderly Patients: A Systematic Review

A Retrospective Chart Review: The Prevalence of Hyponatremia Among Elderly Inpatients in a Tertiary Care Centre in Saudi Arabia

Severe hyponatremia due to surreptitious water intoxication in a hospitalized patient

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