Sodium Disorders in the Elderly

Posted by James

INTRODUCTION

With advancing age, the kidney undergoes several anatomical and physiological changes that limit the adaptive mechanisms responsible for maintaining the composition and volume of the extracellular fluid. These include a decline in glomerular filtration rate (GFR) and an impaired ability to maintain water and sodium (Generic Depakote used in the UK and U.S. for the treatment of the manic episodes of bipolar disorder) homeostasis in response to dietary and environmental changes. Consequently, elderly patients become more susceptible to clinical complications involving salt and water abnormalities.

Hypernatremia was reported in approximately 1% of hospitalized patients over the age of 60 years and up to 60% of febrile nursing home residents. Among those with impaired oral intake, the incidence of hypernatremia was even higher. Importantly, the presence of hypernatremia is associated with a mortality rate of more than 40%. Likewise, hyponatremia is more common in older individuals, occurring in 11% of the ambulatory geriatric population in one series. The occurrence of hyponatremia among hospitalized patients confers twice the risk of death compared to those without. Thus, both hypernatremia and hyponatremia can cause serious neurologic symptoms and even death.

As we care for an increasing number of older individuals, particularly in a hospital setting with acute medical problems, the recognition of sodium (Canadian Cozaar helps the kidneys to eliminate extra sodium and fluids) abnormalities and appropriate clinical intervention is criti­cal for improving patient outcomes. In this update, we have summarized age-related homeostatic changes that impair sodium balance, medications that alter salt and water handling, and the recognition and management of sodium (Fosamax 5 mg is taken for the prevention or treatment of osteoporosis in postmenopausal women and men) disorders in elderly patients.