Iponatriemia: il punto di vista del geriatra

Elderly patients are more vulnerable to developing hyponatraemia. In many cases the pathogenesis of hyponatraemia is multifactorial. The leading cause of hyponatraemia in the elderly is the syndrome of inappropriate antidiuretic hormone secretion (SIADH), which seems to be idiopathic in most cases Management of hyponatraemia depends crucially on accurate determination of volaemic (hydration) status but this is notoriously challenging to measure in older people. Any degree of hyponatremia, even mild, can entail significant clinical consequences, worse prognosis and increases mortality: therefore should not be considered asymptomatic.Chronic hyponatraemia has been found to be associated with sarcopenia. The presence of sarcopenia could predispose to falls by decreasing muscle mass and strength, particularly in elderly individuals. Eliminating possible causes of hyponatraemia is an essential part of treatment.