Prevalence and documented causes of hyponatraemia among geriatric patients attending a primary care clinic

Chai Li Tay (Corresponding Author), Phyo Kyaw Myint, Mohazmi Mohamed, Roy L. Soiza, Maw Pin Tan

Research output: Contribution to journalArticle

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Abstract

INTRODUCTION: Hyponatraemia is the commonest electrolyte abnormality and has major clinical implications. However, few studies of hyponatraemia in the primary care setting has been published to date. OBJECTIVES: To determine the prevalence, potential causes and management of hyponatraemia and to identify factors associated with severity of hyponatraemia among older persons in a primary care setting. METHODS: Electronic records were searched to identify all cases aged ≥60 years with a serum sodium <135mmol/l, attending outpatient clinic in 2014. Patients’ medical records with the available blood test results of glucose, potassium, urea and creatinine were reviewed. RESULTS: Of the 21,544 elderly, 5873 patients (27.3%) had electrolyte profile tests. 403 (6.9%) had hyponatraemia in at least one blood test. Medical records were available for 253, mean age 72.9±7.3 years, 178 (70.4%) had mild hyponatraemia, 75 (29.6%) had moderate to severe hyponatraemia. Potential causes were documented in 101 (40%). Patients with moderate to severe hyponatraemia were five times more likely to have a cause of hyponatraemia documented (p<0.01). Medications were the commonest documented cause of hyponatraemia (31.7%). Hydrochlorothiazide use was attributed in 25 (78.1%) of 32 with medication-associated hyponatraemia. Repeat renal profile (89%) was the commonest management of hypotonic hyponatraemia. CONCLUSION: Whilst hyponatraemia was common in the clinic setting, many cases were not acknowledged and had no clear management strategies. In view of mild hyponatraemia has deleterious consequences, future studies should determine whether appropriate management of mild hyponatraemia will lead to clinical improvement.
Original languageEnglish
Pages (from-to)121-127
Number of pages7
JournalThe Medical Journal of Malaysia
Volume74
Issue number2
Publication statusPublished - Apr 2019

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Hyponatremia
Geriatrics
Primary Health Care
Hematologic Tests
Electrolytes
Medical Records
Hydrochlorothiazide
Ambulatory Care Facilities
Urea

Keywords

  • Hyponatraemia
  • aged
  • electrolytes
  • Sodium

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Prevalence and documented causes of hyponatraemia among geriatric patients attending a primary care clinic. / Tay, Chai Li (Corresponding Author); Myint, Phyo Kyaw; Mohamed, Mohazmi; Soiza, Roy L.; Tan, Maw Pin.

In: The Medical Journal of Malaysia, Vol. 74, No. 2, 04.2019, p. 121-127.

Research output: Contribution to journalArticle

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abstract = "INTRODUCTION: Hyponatraemia is the commonest electrolyte abnormality and has major clinical implications. However, few studies of hyponatraemia in the primary care setting has been published to date. OBJECTIVES: To determine the prevalence, potential causes and management of hyponatraemia and to identify factors associated with severity of hyponatraemia among older persons in a primary care setting. METHODS: Electronic records were searched to identify all cases aged ≥60 years with a serum sodium <135mmol/l, attending outpatient clinic in 2014. Patients’ medical records with the available blood test results of glucose, potassium, urea and creatinine were reviewed. RESULTS: Of the 21,544 elderly, 5873 patients (27.3{\%}) had electrolyte profile tests. 403 (6.9{\%}) had hyponatraemia in at least one blood test. Medical records were available for 253, mean age 72.9±7.3 years, 178 (70.4{\%}) had mild hyponatraemia, 75 (29.6{\%}) had moderate to severe hyponatraemia. Potential causes were documented in 101 (40{\%}). Patients with moderate to severe hyponatraemia were five times more likely to have a cause of hyponatraemia documented (p<0.01). Medications were the commonest documented cause of hyponatraemia (31.7{\%}). Hydrochlorothiazide use was attributed in 25 (78.1{\%}) of 32 with medication-associated hyponatraemia. Repeat renal profile (89{\%}) was the commonest management of hypotonic hyponatraemia. CONCLUSION: Whilst hyponatraemia was common in the clinic setting, many cases were not acknowledged and had no clear management strategies. In view of mild hyponatraemia has deleterious consequences, future studies should determine whether appropriate management of mild hyponatraemia will lead to clinical improvement.",
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note = "FUNDING STATEMENT The authors of the study has received a University of Malaya Grand Challenge Research fund (GC002A-14HTM). ACKNOWLEDGEMENTS We would like to acknowledge the efforts of Prof Dr Ng Chirk Jenn in his assistance with patient data retrieval, and Mdm Chen Yeng Peng from the Clinical Medical Biochemistry Laboratory, and Mdm Ruziah binti Daud from the Department of Patient Information, UMMC for their assistance with case identification.",
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