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.
Treatment for low blood sodium cutting back on fluid intake. adjusting the dosage of diuretics. taking medications for symptoms such as headaches, nausea, and seizures. treating underlying conditions. infusing an intravenous (IV) sodium solution.
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.
The symptoms of hyponatremia tend to be neurologic. Patients may complain of headache , nausea and vomiting , lethargy, and confusion . If the sodium concentration drops quickly to critical levels, seizures , coma , and death may occur.
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.
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.
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 .
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.
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 .
Summary: Older adults with even mildly decreased levels of sodium in the blood ( hyponatremia ) experience increased rates of fractures and falls , according to a new study. Falls are a serious health problem for the elderly and account for about 50 percent of deaths due to injury in the elderly.
Complications related to hyponatremia include rhabdomyolysis, seizures, permanent neurologic sequelae related to ongoing seizures or cerebral edema, respiratory arrest, and death.
In acute hyponatremia , sodium levels drop rapidly — resulting in potentially dangerous effects, such as rapid brain swelling, which can result in a coma and death. Premenopausal women appear to be at the greatest risk of hyponatremia -related brain damage.
The most common manifestations of hyponatremia are CNS-related and include mental status changes such as lethargy, confusion, disorientation, and agitation. Other symptoms such as nausea, vomiting, and weakness can also occur. Severe hyponatremia may result in cerebral edema, encephalopathy and death.