Hyponatremia is more common in older adults because they’re more likely to take medications or have medical conditions that put them at risk of the disorder. These risk factors include: Drugs that make you urinate more (diuretics) Some types of antidepressants.
What Causes Low Sodium in Elderly People? Medications such as diuretics, some types of antidepressants, and anti-seizure medications. Decreased liver, heart, or kidney function. Illnesses that can cause dehydration such as pneumonia.
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).
Hyponatremia and hypernatremia are common in the elderly, particularly among those who are hospitalized or living in long-term care facilities. Hyponatremia is defined as a serum sodium concentration of less than 137 mEq per L (137 mmol per L).
Hyponatremia occurs when your blood sodium level goes below 135 mEq/L. When the sodium level in your blood is too low, extra water goes into your cells and makes them swell. This swelling can be dangerous especially in the brain, since the brain cannot expand past the skull.
In general, hyponatremia is treated with fluid restriction (in the setting of euvolemia), isotonic saline (in hypovolemia), and diuresis (in hypervolemia). A combination of these therapies may be needed based on the presentation. Hypertonic saline is used to treat severe symptomatic hyponatremia.
Generally, low sodium is asymptomatic (does not produce symptoms), when it is mild or related to your diet. It can take weeks or months for you to experience the effects of low salt in your diet—and these effects can be corrected by just one day of normal salt intake.
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.
Complications related to hyponatremia include rhabdomyolysis, seizures, permanent neurologic sequelae related to ongoing seizures or cerebral edema, respiratory arrest, and death.
Hyponatremia can result from multiple diseases that often are affecting the lungs, liver or brain, heart problems like congestive heart failure, or medications. Most people recover fully with their doctor’s help.
For normovolemic (euvolemic), asymptomatic hyponatremic patients, free water restriction (< 1 L/d) is generally the treatment of choice.
Hypovolemic hyponatremia: Administer isotonic saline to patients who are hypovolemic to replace the contracted intravascular volume (thereby treating the cause of vasopressin release). Patients with hypovolemia secondary to diuretics may also need potassium repletion, which, like sodium, is osmotically active.
Although there is no concrete evidence that the restoration of hyponatremia is associated with improved outcome, it is prudent to correct low sodium concentration even in “asymptomatic elderly individuals” because it is related to increased mortality and morbidity (eg, gait disturbances, falls, cognition impairment).
Hyponatremia worsens the prognosis of heart and renal failure and increases mortality in hospitalized patients [27,28,29].
In severe cases, hypernatremia can lead to coma and death. Hypotonic dehydration (hyponatremia). Hyponatremia is what happens when you have too little sodium in your body. This can happen if you lose electrolytes and fluids together but only replace the lost fluids.