Hyponatremia in the elderly: etiologies, implications and therapy

Abstract

Hyponatremia is the most common electrolyte disturbance seen in the elderly. For the vast majority of patients, the serum sodium is mildly decreased and has been a chronic condition. Most clinicians have viewed mild, chronic hyponatremia in elderly patients as a benign condition of little significance. However, recent studies have clearly demonstrated an association between hyponatremia and increased risk for mortality, falls, gait abnormalities, fractures, osteoporosis and cognitive abnormalities. Furthermore, the availability of a safe, oral medication to treat hyponatremia (the vasopressin receptor type 2 antagonists) will allow for the assessment of whether correction of hyponatremia is associated with improvements in outcomes in elderly patients. This finding could have important public health implications.