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Antimicrobials Induced hyponatremia in elderly patients


Urology & Nephrology Open Access Journal
Abdullah Elhosiny,1 Ahmed Akl,1,2,3 Nezar Bahabri1,2,3

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Abstract

Low serum sodium concentration is not an uncommon frequent electrolyte disorder in the elderly population because of multiple risk factors contributing to increased antidiuretic hormone,  the  frequent  prescription  of  drugs  associated  with  hyponatremia,  and  also because of other mechanisms, such as the “tea and toast” syndrome. Herein, we focus on antibiotics’ rare contribution to hyponatremia in elderly. Hyponatremia in elderly subjects is  mainly  induced  by  medications  (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.  Special attention is needed in the elderly population to exclude endocrinopathies as a cause of hyponatremia before establishing the diagnosis of SIAD, which then requires a stepped diagnostic approach to reveal its underlying cause. The treatment of hyponatremia depends on the type of hyponatremia and special attention is also needed to correct serum sodium levels at the appropriate rate, especially in chronic hyponatremia, in order to avoid the osmotic demyelination syndrome. In conclusion, both the evaluation and the treatment of hyponatremia constitute many challenges in the elderly population.

Keywords

antibiotics in aging patients, hyponatremia, acute kidney injury, intestinal nephritis

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