CHAPTER


DOI :10.26650/B/CH12CH47.2023.014.11   IUP :10.26650/B/CH12CH47.2023.014.11    Full Text (PDF)

Yaşlılarda Sıvı Ve Elektroli̇t Bozuklukları Ve Tedavi̇si̇

Şebnem Karakan

Tıbbi bakımdaki gelişmeler son yıllarda yaşlanan nüfusun artmasına neden olmuştur ve 20 yıl içinde iki katına çıkacağı tahmin edilmektedir.1 Yaşlı bireylerde düşük sosyo-ekonomik düzey, komorbidite, polifarmasi; sıvı ve elektrolit bozukluklarının temel nedenleri arasındadır2 . Ayrıca, fiziksel engeller, inkontinans endişesi suya erişimi sınırlandırarak dehidrasyonu kolaylaştırır. 



References

  • 1. Liamis G, Rodenburg EM, Hofman A, Zietse R, Stricker BH, Hoorn EJ. Electrolyte disorders in community subjects: prevalence and risk factors. Am J Med. 2013;3:256-263. google scholar
  • 2. Schlanger LE, Bailey JL, Sands JM. Electrolytes in the aging. Adv Chronic Kidney Dis.2010;17:308-19 google scholar
  • 3. Leiper JB, Seonaid Primrose C, Primrose WR, Phillimore J, Maughan RJ. A comparison of water turnover in older people in community and institutional settings. J Nutr Health Aging.2005;9:189-93. google scholar
  • 4. Allison SP, Lobo DN. Fluid and electrolytes in the elderly. Curr Opin Clin Nutr Metab Care.2004;7:27-33. google scholar
  • 5. Burrell LM, Lambert HJ, Baylis PH. Effect of atrial natriuretic peptide on thirst and arginine vasopressin release in humans. Am J Physiol.1991;260:75-9. google scholar
  • 6. Ohashi M, Fujio N, Nawata H et al. High plasma concentrations of human atrial natriuretic polypeptide in aged men. J Clin Endocrinol Metab.1987;64:81-5. google scholar
  • 7. Asplund R, Aberg H. Diurnal variation in the levels of antidiuretic hormone in the elderly. J Intern Med.1991;229:131-4 google scholar
  • 8. Kurtz A, Della Bruna R, Pfeilschifter J, Taugner R, Bauer C. Atrial natriuretic peptide inhibits renin release from juxtaglomerular cells by a cGMP-mediated process. Proc Natl Acad.1986;83:4769-73. google scholar
  • 9. El-Sharkawy A, Sahota O, Maughan R, Lobo D. The pathophysiology of fluid and electrolyte balance in the older adult surgical patient. Clin Nutr. 2014;1:6-13. google scholar
  • 10. Lindner G, Pfortmuller CA, Leichtle AB, Fiedler GM, Exadaktylos AK. Age-related variety in electrolyte levels and prevalence of dysnatremias and dyskalemias in patients presenting to the emergency department. Gerontology. 2014;5:420-423. google scholar
  • 11. Upadhyay A, Jaber BL, Madias NE. Epidemiology ofhyponatremia. Semin Nephrol. 2009;3:227-238. google scholar
  • 12. Epstein M, Hollenberg NK. Renal “salt wasting” despite apparently normal renal, adrenal and central nervous system function. Nephron. 1979;24:121- 126 google scholar
  • 13. Phillips PA, Rolls BJ, Ledingham JG, et al. Reduced thirst after water deprivation in healthy elderly men. N Engl J Med 1984;311:753-9. google scholar
  • 14. Phillips PA, Bretherton M, Johnston CI, Gray L. Reduced osmotic thirst in healthy elderly men. Am J Physiol 1991;261:166-71. google scholar
  • 15. Adan A. Cognitive performance and dehydration. J Am Coll Nutr 2012;31:71-8 google scholar
  • 16. Phillips PA, Rolls BJ, Ledingham JGG, et al. Reduced thirst after water-deprivation in healthy elderly men. N Engl J Med 1984;311:753-9. google scholar
  • 17. Grandjean AC, Grandjean NR. Dehydration and cognitive performance. J Am Coll Nutr 2007;26:549-54. google scholar
  • 18. Bagshaw SM, Brophy PD, Cruz D, Ronco C. Fluid balance as a biomarker: impact of fluid overload on outcome in critically ill patients with acute kidney injury. Crit Care 2008;12:169-72. google scholar
  • 19. Payen D, de Pont AC, Sakr Y, Spies C, Reinhart K, Vincent JL. A positive fluid balance is associated with a worse outcome in patients with acute renal failure. Crit Care 2008;12:74-85. google scholar
  • 20. Shimizu M, Kinoshita K, Hattori K, et al. Physical signs of dehydration in the elderly. Intern Med 2012;51:1207-10. google scholar
  • 21. Woodrow P. Assessing fluid balance in older people: fluid needs. Nurs Older People 2002;14:31-2. google scholar
  • 22. Hoorn E, Rivadeneira F, Meurs J, et al. Mild hyponatremia as a risk factor for fractures: the Rotterdam Study. J Bone Miner Res. 2011;8:1822-8. google scholar
  • 23. Miller M, Morley JE, Rubenstein LZ. Hyponatremia in a nursing home population. J Am Geriatr Soc. 1995;12:1410-13. google scholar
  • 24. Hawkins RC. Age and gender as risk factors for hyponatremia and hypernatremia. Clin Chim Acta. 2003;337:169-72. google scholar
  • 25. Frenkel WN, van den Born BJ, van Munster BC, Korevaar JC, Levi M, de Rooij SE. The association between serum sodium levels at time of admission and mortality and morbidity in acutely admitted elderly patients: a prospective cohort study. J Am Geriatr Soc. 2010;11:2227-28. google scholar
  • 26. Mannesse CK, Vondeling AM, van Marum RJ, van Solinge WW, Egberts TC, Jansen PA. Prevalence of hyponatremia on geriatric wards compared to other settings over four decades: a systematic review. Ageing Res Rev. 2013;12:165-173. google scholar
  • 27. Renneboog B, Musch W, Vandemergel X, Manto MU, Decaux G. Mild chronic hyponatremia is associated with falls, unsteadiness, and attention deficits. Am J Med. 2006;119:711-18. google scholar
  • 28. Gosch M, Joosten-Gstrein B, Heppner HJ, Lechleitner M. Hyponatremia in geriatric inhospital patients: effects on results of a comprehensive geriatric assessment. Gerontology. 2012;58:430-40. google scholar
  • 29. Klopotowska JE, Wierenga PC, Smorenburg SM, et al. Recognition of adverse drug events in older hospi-talized medical patients. Eur J Clin Pharmacol 2013;69:75-85. google scholar
  • 30. Thomsen LA, Winterstein AG, Sondergaard B, Haugbolle LS, Melander A. Systematic review of the incidence and characteristics of preventable adverse drug events in ambulatory care. Ann Pharmacother 2007;41:1411-26. google scholar
  • 31. Liamis G, Milionis H, Elisaf M. A review of drug-induced hyponatremia. Am J Kidney Dis. 2008;52:144-53. google scholar
  • 32. Liamis G, Filippatos TD, Elisaf MS. Electrolyte disorders associated with the use of anticancer drugs. Eur J Pharmacol. 2016;777:78-87. google scholar
  • 33. Ware JS, Wain LV, Channavajjhala SK, et al. Phenotypic and pharmacogenetic evaluation of patients with thiazide-induced hyponatremia. J Clin Invest. 2017;127:3367-74. google scholar
  • 34. Filippatos T, Tzavella E, Rizos C, Elisaf M, Liamis G. Acid-base and electrolyte disorders associated with the use of antidiyabetic drugs. Expert Opin Drug Saf. 2017;16:1121-32 google scholar
  • 35. Nanne J Frenkel 1, Liffert Vogt, Sophia E De Rooij, Christiane Trimpert, Marcel M Levi, Peter M T Deen, Bert-Jan H van den Born. Thiazide-induced hyponatraemia is associated with increased water intake and impaired ureamediated water excretion at low plasma antidiuretic hormone and urine aquaporin-2. J Hy-pertens. 2015;33:627-33. google scholar
  • 36. Liamis G, Filippatos TD, Elisaf MS. Thiazide-associated hyponatremia in the elderly: what the clinician needs to know. J Geriatr Cardiol. 2016; 13:175-182. google scholar
  • 37. Chow KM, Kwan BC, Szeto CC. Clinical studies of thiazide-induced hyponatremia. J Natl Med Assoc. 2004;96:1305-1308. google scholar
  • 38. Sardar GK, Eilbert WP. Severe hyponatremia associated with thiazide diuretic use. J Emerg Med. 2015;48:305-309. google scholar
  • 39. George Liamis, Theodosios D Filippatos, and Moses S Elisaf. Thiazide-associated hyponatremia in the elderly: what the clinician needs to know. J Geriatr Cardiol. 2016;13:175-182. google scholar
  • 40. Ellison DH, Loffing J. Thiazide effects and adverse effects: insights from molecular genetics. Hypertension. 2009;54:196-202. google scholar
  • 41. Clayton JA, Rodgers S, Blakey J, Avery A, Hall IP. Thiazide diuretic prescription and electrolyte abnorma-lities in primary care. Br J Clin Pharmacol. 2006;61:87-95. google scholar
  • 42. Viramontes TS, Truong H, Linnebur SA. Antidepressant-induced hyponatremia in older adults. Consult Pharm. 2016;31:139-150. google scholar
  • 43. Greenblatt HK, Greenblatt DJ. Antidepressant-associated hyponatremia in the elderly. J Clin Psychophar-macol. 2016;36:545-549. google scholar
  • 44. Lu X, Wang X. Hyponatremia induced by antiepileptic drugs in patients with epilepsy. Expert Opin Drug Saf. 2017;16:77-87. google scholar
  • 45. Gandhi S, McArthur E, Mamdani MM, et al. Antiepileptic drugs and hyponatremia in older adults: two population-based cohort studies. Epilepsia. 2016;57:2067-2079. google scholar
  • 46. Anpalahan M. Chronic idiopathic hyponatremia in older people due to syndrome of inappropriate antidiu-retic hormone secretion (SIADH) possibly related to aging. J Am Geriatr Soc. 2001;49:788-792. google scholar
  • 47. Hirshberg B, Ben-Yehuda A. The syndrome of inappropriate antidiuretic hormone secretion in the elderly. Am J Med. 1997;103:270-273. google scholar
  • 48. Verbalis JG, Goldsmith SR, Greenberg A, et al. Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med. 2013;126:S1-S42. google scholar
  • 49. Wald R, Jaber BL, Price LL, Upadhyay A, Madias NE. Impact of hospital-associated hyponatremia on selected outcomes. Arch Intern Med. 2010;170:294-302. google scholar
  • 50. Spasovski G, Vanholder R, Allolio B, et al. Clinical practice guideline on diagnosis and treatment of hypo-natraemia. Nephrol Dial Transplant. 2014;29:1-39. google scholar
  • 51. Filippatos TD, Liamis G, Elisaf MS. Ten pitfalls in the proper management of patients with hyponatremia. Postgrad Med. 2016;128:516-522. google scholar
  • 52. Liamis G, Elisaf M. Treatment of hyponatremia: what the clinician needs to know. J Nephrol Res. 2015;1:19-21. google scholar
  • 53. Takei M, Suzuki S, Sato A, et al. Five cases of severe hyponatremia in the elderly successfully treated with low doses of hydrocortisone. Geriatr Gerontol Int. 2009;9:391-394 google scholar
  • 54. Greenberg A, Verbalis JG, Amin AN, et al. Current treatment practice and outcomes. Report of the hypo-natremia registry. Kidney Int. 2015;88:167-177. google scholar
  • 55. Liamis G, Filippatos TD, Elisaf MS. Correction of hypovolemia with crystalloid fluids: individualizing infusion therapy. Postgrad Med. 2015; 127:405-412. google scholar
  • 56. Berl T, Rastegar A. A patient with severe hyponatremia and hypokalemia: osmotic demyelination following potassium repletion. Am J Kidney Dis. 2010;55:742-748. google scholar
  • 57. Dellabarca C, Servilla KS, Hart B, Murata GH, Tzamaloukas AH. Osmotic myelinolysis following chro-nic hyponatremia corrected at an overall rate consistent with current recommendations. Int Urol Nephrol. 2005;37:171-173. google scholar
  • 58. Snell DM, Bartley C. Osmotic demyelination syndrome following rapid correction of hyponatraemia. Ana-esthesia. 2008;63:92-95. google scholar
  • 59. Tavare AN, Murray D. Central pontine myelinolysis. N Engl J Med. 2016; 374:8-12. google scholar
  • 60. Lohr JW. Osmotic demyelination syndrome following correction of hyponatremia: association with hypo-kalemia. Am J Med. 1994;96: 408-413. google scholar
  • 61. Moritz ML, Ayus JC. Maintenance intravenous fluids in acutely ill patients. N Engl J Med. 2015;373:1350-60. google scholar
  • 62. El Gkotmi N, Kosmeri C, Filippatos TD, Elisaf MS. Use of intravenous fluids/solutions: a narrative review. Curr Med Res Opin. 2017;33: 459-471. google scholar
  • 63. Spasovski G, Vanholder R, Allolio B, et al. Clinical practice guideline on diagnosis and treatment of hypo-natraemia. Nephrol Dial Transplant. 2014;29:1-39. google scholar
  • 64. Chapman MD, Hanrahan R, McEwen J, Marley JE. Hyponatraemia and hypokalaemia due to indapamide. Med J Aust 2002;176:219-21. google scholar
  • 65. DeFronz RA. Hyperkalemia and hyporeninemic hypoaldosteronism. Kidney Int. 1980;17;118-134 google scholar
  • 66. DeFronzo RA, Lee, R Jones, Bia M. Effect of insulinopenia and adrenal hormone deficiency on acute po-tassium tolerance. Kidney Int. 1980;17:586-594 google scholar
  • 67. Agarwal BN, Cabebe FG. Renal acidification in elderly subjects. Nephron. 1980;26;291-295 google scholar
  • 68. Portale AA, Lonergan ET, Tanney DM, Halloran BP. Aging alters calcium regulation of serum concentration of parathyroid hormone in healthy men. Am J Physiol. 1997;272:139-146 google scholar
  • 69. Baumgartner TG. Magnesium assessment: is it worth the work? Adv Gastroenterol Hepatol Clin Nutr. 1997;22:13-216 google scholar
  • 70. Musso C, Liakopoulos V, De Miguel R, Imperiali N, Algranati L. Transtubular potassium concentrati-on gradient: comparison between healthy old people and chronic renal failure patients. Int Urol Nephrol. 2006;38:387-90. google scholar
  • 71. Rylander R, Remer T, Berkemeyer S, Vormann J. Acid-base status affects renal magnesium losses in healthy, elderly persons. J Nutr 2006;136:2374-7. google scholar


SHARE




Istanbul University Press aims to contribute to the dissemination of ever growing scientific knowledge through publication of high quality scientific journals and books in accordance with the international publishing standards and ethics. Istanbul University Press follows an open access, non-commercial, scholarly publishing.