Hyponatremia: age-related risk factors and therapy decisions

Normal aging is accompanied by many changes in the regulatory systems that control sodium and water balance, as well as diminished capacity to withstand the challenges of illness, drugs, and physiologic stresses. Consequently, the older person is at an increased risk for clinically significant alterations in sodium and water balance, especially hyponatremia. Awareness of these risk factors allows the physician to anticipate the impact of illnesses and drugs on volume and electrolyte status of the older patient and to implement a rational approach to therapeutic intervention and management.