Dr. Vivek Lakhawat, Dr. Anil Sankhla, Dr. Arvind K. Jain



          Hyponatremia is most common electrolyte imbalance in geriatric patients. Determining etiologies of such patients would help in identifying candidates  for future prevention.


          We had studied 50 patients of hyponatremia with altered sensorium in geriatric age group. These patients were evaluated for the underlying cause of hyponatremia and hormones involved in hyponatremia.


           Most common cause was CVA (32%), followed by CHF (30%), diuretics (28%), renal failure  (26%) , hypothyroidism (10%), pneumonia (10% ),  adrenal insufficiency (10%), liver disease (8%) and ICSOL (2%). Among hormones, vasopression was raised in 96% patients, glucocorticoid and minrealocorticoid was diminished in 10% patients and aldosterone was diminished in 6% patients.

DISCUSSION – Hyponatremia is a common problem in hospital more so in critically ill ICU patients. The possible cause of hyponatremia should always be sought as an outcome in severe hyponatremia is governed by etiology and not by serum level of sodium.


Hyponatremia, Cause, Hormone.

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Waikar SS, Mount DB, Curhan GC. Mortality after hospitalization with mild, moderate, and severe hyponatremia. Am J Med 2009 Sep;122: 857-865

SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertenrion in the Elderly program (SHEEP). JAMA 1991 Jun 26; 265(24):3255-64.

Pepice CJ, Handberg Em, Cooper-DeHoff RM, et al. A calcium antagonist vs a noncalcium antagonist hypertension treatment strategy for patients with coronary artery disease. The International Verapamil-Trandolapril Study (INVEST): a randomized controlled trial. JAMA. 2003 Dec 3;290(21):2805-16.

Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003 Dec;42(6):1206-52.

Ernest ME, Carter BL, Goerdt CJ, et al. Comparative Antihypertensive Effects of Hydrochlorothiazide and Chlorthalidone on Ambulatory and Office Blood Pressure. Hypertension. 2006 Mar; 47(3):352-358.

Rastogi D, Pelter MA, Deamer RL. Evaluations of hospitalizations associated with thiazde-associated hyponatremia. J Clin Hypertens (Greenwich)- 2012 Jan;14(3):158-64.

Spasovski G, Vanholder R, Allolio B, et al. Clinical practice guidance on diagnosis and treatment of hyponatremia. Nephrol Dial Transplant. 2014 Apr.;29(2):1-39.

Yawar A, Jabbar A, Haque N, et al. Hyponatremia: etiology, management and outcome. J Coll Physicians Surg Pak. 2008 Aug;18(8):467-71.

Mohan S, Gu S, Parikh A, et al. Prevalence of Hyponatremia and Association with Mortality: Results from NHANES. Am J Med. 2013 Dec;126(12):1127-37.

Bennani SL, Abouqual R, Zeggwagh AA, et al. Incidence, causes and prognostic factors of hyponatremia in intensive care. La Revue de Medecine Interne. 2003 Apr; 24(4):224-229.

Sunderam SG, Mankikar GD. Hyponatraemia in the elderly. Age and Ageing. 1983 Jan; 12(1):77-80.

Clayton JA, Le Jeune IR, Hall IP. Severe hyponatraemia in medical in-parients:aetiology, assessment and outcome. Q J Med. 2006 Aug;99:505-11.

Vitteing KE, Gardenswartz MH, Zabetakis PM, et al. Frequency of Hyponatremia and Nonosmolar Vasopression Release in the Acquired Immunodificiency Syndrome. JAMA. 1990 Feb; 263(7):973-978.

Hannon MJ, Behan La, O’Brien MMC et al. Hyponatremia Following Mild/Moderate Subarachnoid Hemorrhage Is Due To SIAD and Glucocorticoid Deficiency and not Cerebral Salt Wasting. The Journal of Clinical Endocrinology & Metabolism. 2014 Jan;99(1):291-298.


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