Management of hyponatraemia in older people: old threats and new opportunities

Roy L Soiza (Corresponding Author), Hannah S C Talbot

Research output: Contribution to journalReview article

23 Citations (Scopus)

Abstract

Hyponatraemia is the commonest electrolyte abnormality seen in clinical practice, and is especially prevalent in frail, older people. However, the serious implications of hyponatraemia in this age group are seldom recognized by clinicians. Hyponatraemia is associated with osteoporosis, impaired balance, falls, hip fractures and cognitive dysfunction. Even mild, apparently asymptomatic hyponatraemia is associated with prolonged stays in hospital, institutionalization and increased risk of death. Emerging evidence of the potential benefits of improved treatment of hyponatraemia is slowly generating renewed clinical interest in this area. The development of specific vasopressin-2 receptor antagonists (vaptans) has the potential to revolutionize the management of hyponatraemia, in particular for the syndrome of inappropriate antidiuretic hormone. However, challenges remain for the attending physician. Diagnosing the cause or causes of hyponatraemia in older people is difficult, and incorrect diagnosis can lead to treatment that worsens the electrolyte imbalance. Established treatments are often poorly tolerated and patient outcomes remain poor, and the role of vaptans in the treatment of older people is unclear. This review summarizes the existing evidence base and highlights areas of controversy. It includes practical guidance for overcoming some common pitfalls in the management of the elderly patient with hyponatraemia.

Original languageEnglish
Pages (from-to)9-17
Number of pages9
JournalTherapeutic Advances in Drug Safety
Volume2
Issue number1
Early online date13 Dec 2010
DOIs
Publication statusPublished - Feb 2011

Keywords

  • Journal Article
  • Review
  • arginine vasopressin
  • elderly
  • hyponatraemia
  • syndrome of inappropriate antidiuretic hormone
  • tolvaptan
  • vasopressin receptor antagonist

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