Symptoms and Characteristics of Individuals with Profound Hyponatremia: A Prospective Multicenter Observational Study

• Autores: Nicole Nigro, Bettina Winzeler, Isabelle Suter Widmer, Philipp Schuetz, Birsen Arici, Martina Bally, Claudine Blum, Roland Bingisser, Andreas Hock, Andreas Huber, Beat Müller, Christian H. Nickel, Mirjan Christ-Crain
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 63, Nº. 3, 2015, págs. 470-475
• Idioma: inglés
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• Resumen

  • Objectives To assess symptoms and characteristics of hyponatremia, the most common electrolyte disturbance in hospitalized individuals and a condition that is associated with substantial morbidity and mortality.

    Design Prospective observational multicenter study.

    Setting Two Swiss academic centers.

    Participants Individuals with profound hypoosmolar hyponatremia (sodium <125 mmol/L) (N = 298).

    Measurements All symptoms and complete medical history including current medications, therapy management, and in-hospital outcomes were recorded.

    Results The median age of all participants was 71 (interquartile range (IQR) 60–80), 195 (65%) were female, and mean serum sodium value on admission was 120 mmol/L (IQR 116–123 mmol/L). Frequent clinical symptoms were nausea (n = 130, 44%), acute vomiting (n = 91, 30%), generalized weakness (n = 205, 69%), fatigue (n = 175, 59%), gait disturbance (n = 92, 31%), recurrent falls (n = 47, 16%), and acute falls (n = 60, 20%). Fractures were reported in 11 participants (4%). More-severe symptoms such as acute epileptic seizures and focal neurological deficits were identified in 16 (5%) and 17 (5%) participants, respectively. The most common comorbidities were hypertension (n = 199, 67%), congestive heart failure (n = 44, 15%), chronic renal failure (n = 64, 21%), pulmonary disease (82, 28%), and central nervous system disease (n = 114, 38%). During hospitalization, 12 (4%) participants died, and 103 (35%) needed treatment in the intensive care unit.

    Conclusion A wide spectrum of symptoms accompanies profound hyponatremia. Most participants had moderate symptoms mirroring chronic hyponatremia with brain cell adaptation. Participants with profound hyponatremia had several comorbidities.