Thiazide-induced hyponatremia in the postoperative total joint replacement patient

The thiazide diuretic is a common medication in the elderly population for the treatment of hypertension. These same patients are the largest population for surgical intervention for joint arthroplasty. Postoperative management of these patients has shown to be complicated by hyponatremia associated with the use of thiazide diuretics. This study evaluates a consecutive series of 408 patients undergoing elective joint arthroplasty. An association was found with the use of thiazide diuretics in the preoperative period and the development of postoperative hyponatremia. The study is presented, along with a relevant review of the literature and suggestions for the orthopedic staff to limit the risk of hypoantremia and prolonged hospitalization in an otherwise stable postoperative course.