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Related Experiment Videos

Failure of intravenous fluid therapies to decrease serum sodium levels in elderly hospitalized patients.

Sharila Krishnan1, Maria V DeVita, Georgia Panagopoulos

  • 1Division of Nephrology, Dept. of Medicine, Lenox Hill Hospital, New York, NY, USA.

International Urology and Nephrology
|August 6, 2003
PubMed
Summary

Elderly patients receiving intravenous fluids did not develop hyponatremia. In fact, many experienced an increase in serum sodium, suggesting fluid administration was often insufficient.

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Area of Science:

  • Geriatrics
  • Nephrology
  • Internal Medicine

Background:

  • Elderly individuals are susceptible to hyponatremia due to altered antidiuretic hormone (ADH) regulation and impaired water excretion.
  • Hospitalized elderly patients may be at risk for electrolyte imbalances, particularly serum sodium levels.

Purpose of the Study:

  • To evaluate changes in serum sodium levels in elderly hospitalized patients undergoing various intravenous fluid therapies.
  • To determine the incidence of hyponatremia in this patient population under specific fluid management protocols.

Main Methods:

  • A study involving 14 elderly hospitalized patients with baseline serum sodium between 136-145 meq/L.
  • Patients received either half normal saline or normal saline intravenously, averaging 1098 mL/day, alongside oral fluids.

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  • Serum sodium, BUN, creatinine, plasma renin activity, aldosterone, ADH, ANP, and osmolalities were monitored over a mean follow-up of 5.9 days.

    • Main Results:

    • No patients developed hyponatremia; 7 out of 14 experienced an increase in serum sodium.
    • Mean follow-up serum sodium was 141.4 meq/L, showing no significant difference from baseline (140.2 meq/L).
    • Renal and hormonal parameters (BUN, creatinine, PRA, aldosterone, ADH, ANP) did not show significant pre- to post-therapy changes.

    Conclusions:

    • Hospitalized elderly patients often maintain stable or increased serum sodium levels when receiving standard intravenous fluids.
    • The study suggests that the total fluid volume administered may be insufficient to cause dilutional hyponatremia in many elderly patients.
    • Current intravenous fluid strategies appear safe regarding serum sodium balance in this demographic, contrary to common concerns about hyponatremia development.