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J. Clin. Med. 2014, 3(3), 944-958; doi:10.3390/jcm3030944

Hyponatremia: Special Considerations in Older Patients

1
Department of Medicine for the Elderly, NHS Grampian, c/o Wards 303/4, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN, UK
2
School of Medicine & Dentistry, University of Aberdeen, Aberdeen AB25 2ZD, UK
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Received: 17 June 2014 / Revised: 7 July 2014 / Accepted: 18 July 2014 / Published: 18 August 2014
(This article belongs to the Special Issue Hyponatremia: Advances in Diagnosis and Management)
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Abstract

Hyponatremia is especially common in older people. Recent evidence highlights that even mild, chronic hyponatremia can lead to cognitive impairment, falls and fractures, the latter being in part due to bone demineralization and reduced bone quality. Hyponatremia is therefore of special significance in frail older people. Management of hyponatremia in elderly individuals is particularly challenging. The underlying cause is often multi-factorial, a clear history may be difficult to obtain and clinical examination is unreliable. Established treatment modalities are often ineffective and carry considerable risks, especially if the diagnosis of underlying causes is incorrect. Nevertheless, there is some evidence that correction of hyponatremia can improve cognitive performance and postural balance, potentially minimizing the risk of falls and fractures. Oral vasopressin receptor antagonists (vaptans) are a promising innovation, but evidence of their safety and effect on important clinical outcomes in frail elderly individuals is limited. View Full-Text
Keywords: aging; arginine vasopressin; geriatrics; hyponatremia; old; salt; sodium aging; arginine vasopressin; geriatrics; hyponatremia; old; salt; sodium
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MDPI and ACS Style

Soiza, R.L.; Cumming, K.; Clarke, J.M.; Wood, K.M.; Myint, P.K. Hyponatremia: Special Considerations in Older Patients. J. Clin. Med. 2014, 3, 944-958.

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