Hyponatremia: practical considerations in the acute geriatric setting


Submitted: 2 September 2023
Accepted: 5 March 2024
Published: 25 March 2024
Abstract Views: 1280
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Authors

In older adults, hyponatremia often represents a medical emergency and is frequently associated with neurological manifestations or symptomatic pictures that the clinician mistakes for other pathologies. This paper deals with some practical considerations in the assessment and management of hyponatremia in older adults in the acute care setting, following the clinical discussion that took place at the Soave (Italy) meeting convened by the scientific committee of the Italian Society of Geriatrics Hospital and Territory.


Verbalis JG. Disorders of body water homeostasis. Best Pract Res Clin Endocrinol Metab 2003;17:471-503. DOI: https://doi.org/10.1016/S1521-690X(03)00049-6

Verbalis JG, Goldsmith SR, Greenberg A, et al. Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med 2013;126:S1-42. DOI: https://doi.org/10.1016/j.amjmed.2013.07.006

Wald R, Jaber BL, Price LL, et al. Impact of hospital-associated hyponatremia on selected outcomes. Arch Intern Med 2010;170:294-302. DOI: https://doi.org/10.1001/archinternmed.2009.513

Shapiro DS, Sonnenblick M, Galperin I, et al. Severe hyponatremia in elderly hospitalized patients: prevalence, etiology and outcome. Intern Med J 2010;40:574-80. DOI: https://doi.org/10.1111/j.1445-5994.2010.02217.x

Spasovski G, Vanholder R, Allolio B, et al. Hyponatremia guideline development group. clinical practice guideline on diagnosis and treatment of hyponatremia. Eur J Endocrinol 2014;170:G1-47. Erratum in: Eur J Endocrinol 2014;171:X1. DOI: https://doi.org/10.1530/EJE-13-1020e

Hoorn EJ, Zietse R. Diagnosis and treatment of hyponatremia: compilation of the guidelines. J Am Soc Nephrol 2017;28:1340-9. DOI: https://doi.org/10.1681/ASN.2016101139

Braun MM, Barstow CH, Pyzocha NJ. Diagnosis and management of sodium disorders: hyponatremia and hypernatremia. Am Fam Physician 2015;91:299-307.

Woodward M, Gonski P, Grossmann M, et al. Diagnosis and management of hyponatraemia in the older patient. Intern Med J 2018;48:5-12. DOI: https://doi.org/10.1111/imj.13682

Carlotti AP, Bohn D, Mallie JP, et al. Tonicity balance, and not electrolyte-free water calculations, more accurately guides therapy for acute changes in natremia. Intensive Care Med 2001;27:921-4. DOI: https://doi.org/10.1007/s001340100911

Hillier TA, Abbott RD, Barrett EJ. Hyponatremia: evaluating the correction factor for hyperglycemia. Am J Med 1999;106:399-403. DOI: https://doi.org/10.1016/S0002-9343(99)00055-8

Parenti G, Ricca V, Zogheri A, et al. A case of hyponatremia caused by central hypocortisolism. Nat Clin Pract Endocrinol Metab 2007;3:369-75. DOI: https://doi.org/10.1038/ncpendmet0459

Schwartz WB, Bennett W, Curlop S, et al. Hyponatraemia in cases of lung carcinoma. Am J Med 1957;23:529. DOI: https://doi.org/10.1016/0002-9343(57)90224-3

Finley JJ 4th, Konstam MA, Udelson JE. Arginine vasopressin antagonists for the treatment of heart failure and hyponatremia. Circulation 2008;118:410-21. Erratum in: Circulation 2009;119:e552. DOI: https://doi.org/10.1161/CIRCULATIONAHA.108.765289

Filippatos TD, Liamis G, Christopoulou F, Elisaf MS. Ten common pitfalls in the evaluation of patients with hyponatremia. Eur J Intern Med 2016;29:22-5. DOI: https://doi.org/10.1016/j.ejim.2015.11.022

Feldman BJ, Rosenthal SM, Vargas GA, et al. Nephrogenic syndrome of inappropriate antidiuresis. N Engl J Med 2005;352:1884-90. DOI: https://doi.org/10.1056/NEJMoa042743

Janicic N, Verbalis JG. Evaluation and management of hypo-osmolality in hospitalized patients. Endocrinol Metab Clin North Am 2003;32:459-81, vii. DOI: https://doi.org/10.1016/S0889-8529(03)00004-5

Liamis G, Milionis H, Elisaf M. A review of drug-induced hyponatremia. Am J Kidney Dis 2008;52:144-53. DOI: https://doi.org/10.1053/j.ajkd.2008.03.004

Sherlock M, O’Sullivan E, Agha A, et al. The incidence and pathophysiology of hyponatremia after subarachnoid haemorrhage. Clin Endocrinol (Oxf) 2006;64:250-4. DOI: https://doi.org/10.1111/j.1365-2265.2006.02432.x

Verbalis JG, Barsony J, Sugimura Y, et al. Hyponatremia-induced osteoporosis. J Bone Miner Res 2010;25:554-63. DOI: https://doi.org/10.1359/jbmr.090827

Gankam Kengne F, Andres C, Sattar L, et al. Mild hyponatremia and risk of fracture in the ambulatory elderly. QJM 2008;101:583-8. DOI: https://doi.org/10.1093/qjmed/hcn061

Tolouian R., Alhamad T., Farazmand M, et al. The correlation of hip fracture and hyponatremia in the elderly. J Nephrol 2012;25:789-93. DOI: https://doi.org/10.5301/jn.5000064

Negri AL, Ayus JC. Hyponatremia and bone disease. Rev Endocr Metab Disord 2017;18:67-78. DOI: https://doi.org/10.1007/s11154-016-9387-7

Verbalis JG, Goldsmith SR, Greenberg A, et al. Hyponatremia treatment guidelines 2007: expert panel recommendations. Am J Med 2007;120:S1-21. DOI: https://doi.org/10.1016/j.amjmed.2007.09.001

Fleming, JD; Babu S. Images in clinical medicine. Central pontine myelinolysis. N Engl J Med 2008;359:e29. DOI: https://doi.org/10.1056/NEJMicm066005

Li S, Xiao X, Zhang X. Hydration status in older adults: current knowledge and future challenges. Nutrients 2023;15:2609. DOI: https://doi.org/10.3390/nu15112609

DeGoma E, Vagelos R, Fowler M, et al. Emerging therapies for the management of decompensated heart failure: from bench to bedside. J Am Coll Cardiol 2006;48:2397-409. DOI: https://doi.org/10.1016/j.jacc.2006.08.039

Adrogue HJ, Madias NE. Hyponatremia. N Engl J Med 2000;342:1581-9. DOI: https://doi.org/10.1056/NEJM200005253422107

Verbalis JG, Adler S, Schrier RW, et al. Efficacy and safety of oral tolvaptan therapy in patients with the syndrome of inappropriate antidiuretic hormone secretion. Eur J Endocrinol 2011;164:725-32. DOI: https://doi.org/10.1530/EJE-10-1078

Decaux G. Is asymptomatic hyponatremia really asymptomatic?. Am J Med 2006;119:S79-82. DOI: https://doi.org/10.1016/j.amjmed.2006.05.013

Filippatos TD, Makri A, Elisaf MS, et al. Hyponatremia in the elderly: challenges and solutions. Clin Interv Aging 2017;12:1957-65. DOI: https://doi.org/10.2147/CIA.S138535

Vitali, A., Dini, S., Cozza, M., Rossi, F. F., Boccardi, V., & Brunori, M. (2024). Hyponatremia: practical considerations in the acute geriatric setting. Geriatric Care, 10(1). https://doi.org/10.4081/gc.2024.11711

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