Hyponatremia in elderly subjects is mainly caused by drugs (more frequently thiazides and antidepressants), the syndrome of inappropriate antidiuretic hormone secretion (SIAD) or endocrinopathies; however, hyponatremia is multifactorial in a significant proportion of patients.
Hyponatremia is decrease in serum sodium concentration < 136 mEq/L (< 136 mmol/L) caused by an excess of water relative to solute. Common causes include diuretic use, diarrhea , heart failure , liver disease, renal disease, and the syndrome of inappropriate antidiuretic hormone secretion (SIADH).
Common causes include kidney disease, inadequate water intake and loss of water through vomiting or diarrhoea. People at highest risk of hypernatraemia include: Infants and elderly people who cannot maintain adequate fluid intake without assistance.
Those who have mild to moderate hyponatremia resulting from lifestyle factors or medication may be able to increase sodium to normal levels by: drinking less fluids (often less than 1 quart per day) adjusting medication dose or switching medications.
Hyponatremia treatments may include changing a medication that affects your sodium level, treating the underlying disease, changing the amount of water you drink or changing the amount of salt in your diet.
In elderly patients with a diet poor in protein and sodium , hyponatremia may be worsened by their low solute intake. The kidney’s need to excrete solutes aids in water excretion. An increase in dietary protein and salt can help improve water excretion.
Who is most at risk for hyponatremia? Anyone can develop hyponatremia. Hyponatremia is more likely in people living with certain diseases, like kidney failure, congestive heart failure , and diseases affecting the lungs, liver or brain . It often occurs with pain after surgery.
Overhydration can lead to water intoxication. This occurs when the amount of salt and other electrolytes in your body become too diluted. Hyponatremia is a condition in which sodium (salt) levels become dangerously low. This is the main concern of overhydration.
In patients with severe symptomatic hyponatremia , the rate of sodium correction should be 6 to 12 mEq per L in the first 24 hours and 18 mEq per L or less in 48 hours. A bolus of 100 to 150 mL of hypertonic 3% saline can be given to correct severe hyponatremia .
Potassium deficiency develops slowly in the elderly through symptoms such as fatigue, muscle weakness, cramps, bone fragility, nausea, vomiting, and higher blood sugar. Low potassium can also cause several mood changes in older adults , including confusion , depression, nervous disorders, and erratic behavior.
cup of black coffee has 116 mg of potassium 3. This is considered a low potassium food. However, many people drink more than one cup of coffee each day. Three to four cups of coffee a day is considered high in potassium and could raise your potassium levels.
In many hospital laboratories 160 mEq/L is chosen as the upper critical value. The evidence of this study suggests that sodium in the range of 155-160 mEq/L is associated with high risk of death and that 155 mEq/L rather than 160 mEq/L might be more suitable as the upper critical level .
In hyponatremia, the level of sodium in blood is too low. A low sodium level has many causes, including consumption of too many fluids, kidney failure , heart failure , cirrhosis , and use of diuretics. Symptoms result from brain dysfunction.
Chronic caffeine intake increases urinary sodium excretion without affecting plasma sodium concentration .
High- Sodium Foods Smoked, cured, salted or canned meat, fish or poultry including bacon, cold cuts, ham, frankfurters, sausage, sardines, caviar and anchovies. Frozen breaded meats and dinners, such as burritos and pizza. Canned entrees, such as ravioli, spam and chili. Salted nuts. Beans canned with salt added.