Vol. 3, Issue 7 (2017)
Clinico-etiological profile of Hyponatremia in elderly
Author(s): Dr. Shanmugasundaram Rajamani, Dr. Binu Vazhapilly Pushpangadan MD, Dr. R Shankar
Abstract: Background: The incidence of hyponatremia is much more common in the elderly mainly owing to impaired ability to maintain water and electrolyte homeostasis in response to dietary and environmental changes. Reportedly common underlying causes of hyponatremia include pharmacotherapies, co-morbidities, fluid overload and volume depletion. Aim: To assess the etiological factors responsible for hyponatremia among the elderly hospitalized patients and to describe the clinical manifestations associated with it. Methodology: A prospective longitudinal study was conducted at General Medicine and allied specialities in Vinayaka Mission Kirupananda Variyar Medical College and Hospital, Salem for a period of one year between Jan 2016 to Dec 2016. All patients aged 65years and above with their serum sodium level less than 135meq/L were included in the study. A total of 235 patients were included in the study. Detailed history was obtained from the patients and a complete physical and blood examinations were done to assess the severity of hyponatremia. Results: The mean age of the patients was 68.1 years. Majority of the patients are with moderate hyponatremia (46.8%) followed by severe grade (28.6%) and only 24.6%of them had mild hyponatremia. As the age of the patient increases the severity of hyponatremia also increases and this association was found to be statistically significant (P<.001). Patients with mild and moderate hyponatremia most of their presenting symptoms were non-neurological, whereas patients with severe hyponatremia majority of them presented with neurological symptoms. Hypertension followed by diabetes mellitus was the most common pre-existing illness present among the patients. Among the various aetiologies reported among our study subjects the most common aetiology was found to be drug induced hyponatremia. The second most common cause was reduced intake of sodium followed by SIADH, CCF, CNS lesions and renal diseases. 52% of the patients had more than factor influencing the occurrence of hyponatremia. Conclusion: The most common cause of hyponatremia in elderly is diuretic (Thiazide) or its combination with antihypertensives. Studying the aetiology, risk factors and management of hyponatremia in hospitalized patients will help in reducing its incidence and minimize the complications associated with hyponatremia.