Prevalence of hyponatremia on geriatric wards compared to other settings over four decades: A systematic review

Mannesse, C. K.; Vondeling, Ariël M.; Marum, Rob J. van; Solinge, Wouter W. van; Egberts, Toine C. G.; Jansen, Paul A. F.

doi:10.1016/j.arr.2012.04.006

Cited by 70 publications

(46 citation statements)

References 75 publications

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“…2 Prevalence on a geriatric ward and in long-term institutionalized patients has been found to be as high as 22%. 3,4 A prospective study on medical wards revealed that 6.2% of hospitalized patients over 65 years old presented marked hyponatraemia, with S Na below 125 mmol l −1 . 8 These figures would be even higher if S Na had been corrected for serum total proteins (TP), as outlined below.…”

Section: Incidence Of Hyponatraemia In Older Peoplementioning

confidence: 99%

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Hyponatraemia in older patients: a clinical and practical approach

Rünkle

Gómez-Hoyos

Cuesta-Hernandez

et al. 2015

Rev. Clin. Gerontol.

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Hyponatraemia is frequent in older people and induces marked motor and cognitive dysfunction, even in patients deemed 'asymptomatic'. Nutritional status is worse than in euvolaemic-matched controls, and the risk of fracture is increased following incidental falls. Yet hyponatraemia is undertreated, in spite of the fact that its correction is accompanied by a clear improvement in symptoms. Both evaluation of neurological symptoms and classification by volaemia are essential for a correct diagnosis and treatment of the hyponatraemic elderly patient. The syndrome of inappropriate anti-diuretic hormone secretion (SIADH) is the most common cause of hyponatraemia in older people. Nutritional status and chronicity of SIADH should be taken into account when deciding therapy. We propose an 8-step approach to the management of the elderly patient with hyponatraemia.

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Section: Incidence Of Hyponatraemia In Older Peoplementioning

confidence: 99%

“…Hyponatraemia is frequent in older people, [1][2][3][4] and advanced age is a risk factor for its development. 2 Even mild/moderate hyponatraemia can induce serious symptoms, often undetected in older individuals.…”

Section: Introductionmentioning

confidence: 99%

Hyponatraemia in older patients: a clinical and practical approach

Rünkle

Gómez-Hoyos

Cuesta-Hernandez

et al. 2015

Rev. Clin. Gerontol.

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“…A study of diabetic patients in Riyadh, Saudi Arabia found 87% to be hyponatremic and no difference in prevalence rates for hypokalemia among the cases and controls (Al Jameil, 2014). By comparison, the pooled estimated mean (PEM) for mild hyponatremia from 53 studies in different parts of the world was found to be 22% in geriatric wards, 17% in other hospital wards and 19% in nursing homes (Mannesse et al, 2013). Studies on electrolyte disturbance in cancer patients in the GCC region are even fewer.…”

Section: Desalination and Cancer Incidence In The Gulf Regionmentioning

confidence: 98%

Health effects of desalinated water: Role of electrolyte disturbance in cancer development

Nriagu

Darroudi²,

Shomar

2016

Environmental Research

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“…24 A recent systematic review revealed a prevalence of 6.0% in normal and 22.2% in geriatric wards, respectively. 25 In psychiatry, data exist mainly on specialized psychiatric populations, such as schizophrenia patients with polydipsia (25%), 17 older patients treated with SSRIs or venlafaxine (39%), 18 and inpatients of psychogeriatric wards (7.7%).…”

Section: General and Epidemiological Considerationsmentioning

confidence: 99%

Epidemiology, Symptoms, and Treatment Characteristics of Hyponatremic Psychiatric Inpatients

Lange-Asschenfeldt

Kojda

Cordes³

et al. 2013

Journal of Clinical Psychopharmacology

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Hyponatremia is a common phenomenon in psychiatry occurring as an adverse effect to drugs or following polydipsia. We performed a retrospective in-depth analysis of hyponatremia cases in a large unselected population of psychiatric inpatients. During a 3-year period, all cases of hyponatremia were identified among patients admitted to a large psychiatric state and university hospital by the institution's electronic laboratory database. Demographic, treatmentrelated, and laboratory data were obtained by consecutive chart review, respectively. Hyponatremia occurred in 347 (4.9%) of 7113 cases, of which the majority (78%) displayed only a mild manifestation. Symptoms were recorded in 28.8% of cases, already occurred in mild forms, and comprised gait impairment (45%, including falls), confusion (30%), sedation (26%), and dyspepsia (41%). Age, female sex, nonpsychiatric drug polypharmacyVparticularly with thiazides and/or angiotensinconverting enzyme inhibitorsVand diagnosis of a mood disorder were associated with more severe hyponatremia, respectively. The proportion of hyponatremic patients treated with venlafaxine, trazodone, carbamazepine, oxcarbazepine, and first-generation antipsychotics, respectively, was significantly higher in the hyponatremia sample than in the normonatremic population. This was, surprisingly, not the case with selective serotonin reuptake inhibitors or any other antidepressant drug class. We found prescription with second-generation antipsychotics to be significantly associated with less severe hyponatremia.Hyponatremia may be mainly attributed to the syndrome of inappropriate antidiuretic hormone secretion, as indicated by decreased serum osmolarity in our sample. Besides old age and female sex, treatment with certain drugsVrather than whole drug classesVcarries a substantially increased risk. ] is maintained within tight limits through a complex homeostatic system involving hypothalamic osmoreceptors and peripheral baroreceptors regulating water intake and urine output via changes in thirst and the neurohypophyseal secretion of the antidiuretic hormone arginine-vasopressin (AVP).8 Thus, excessive water intake or inappropriate release of AVP in the absence of osmotic stimuli, respectively are among the most common pathomechanisms of hyponatremia. The latter condition is known as the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and occurs, among an array of other causes, as an adverse effect of a large number of psychotropic and other drugs. 7,9,10 Above all, a wealth of case reports, casecontrol, and population-based studies have implicated antidepressants, such as tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), selective serotonin and norepinephrine reuptake inhibitors (SNRIs), and certain anticonvulsantsVmainly carbamazepine and oxcarbazepineV in hyponatremia of this origin. 11Y13 The most prevalent nonpsychiatric drugs associated with SIADH-induced hyponatremia are thiazide diuretics and angiotensin-converting enzyme inh...

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Prevalence of hyponatremia on geriatric wards compared to other settings over four decades: A systematic review

Cited by 70 publications

References 75 publications

Hyponatraemia in older patients: a clinical and practical approach

Hyponatraemia in older patients: a clinical and practical approach

Health effects of desalinated water: Role of electrolyte disturbance in cancer development

Epidemiology, Symptoms, and Treatment Characteristics of Hyponatremic Psychiatric Inpatients

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