Antimicrobials Induced hyponatremia in elderly patients
- Urology & Nephrology Open Access Journal
Abdullah Elhosiny,1 Ahmed Akl,1,2,3 Nezar Bahabri1,2,3
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.
antibiotics in aging patients, hyponatremia, acute kidney injury, intestinal nephritis