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Hyponatremia in a nursing home population
M Miller1, J E Morley, L Z Rubenstein
1Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, New York, USA.
Journal of the American Geriatrics Society
|December 1, 1995
Summary
Hyponatremia is common in nursing home residents, affecting 18% at any given time and 53% over a year. Central nervous system disease and fluid intake contribute to this condition.
Area of Science:
- Geriatric Medicine
- Endocrinology
- Nephrology
Background:
- Hyponatremia is a prevalent electrolyte imbalance in elderly populations.
- Nursing home residents represent a vulnerable group with unique health challenges.
Purpose of the Study:
- To determine the prevalence of hyponatremia in a nursing home setting.
- To identify clinical factors associated with an increased risk of hyponatremia.
Main Methods:
- Retrospective and prospective record review of 119 nursing home residents (aged 60-103).
- Comparison with 60 ambulatory outpatients (aged 62-91) as a reference population.
- Analysis of serum sodium, creatinine, BUN, clinical diagnoses, diet, medications, and fluid intake.
Main Results:
- 18% of nursing home residents were hyponatremic at the time of the study, compared to 8% in the ambulatory group.
- 53% of nursing home residents experienced at least one hyponatremic episode in the preceding 12 months.
- Hyponatremia was linked to increased fluid intake, tube feeding, and a high incidence of central nervous system (CNS) disease.
Conclusions:
- Hyponatremia is a frequent condition in nursing home residents.
- Abnormal antidiuretic hormone (ADH) secretion, often due to CNS disease, contributes to hyponatremia.
- Increased fluid intake or low-sodium diets can precipitate or exacerbate hyponatremia.