Galperin Ilia, Friedmann Reuven, Feldman Helena, Sonnenblick Moshe
Geriatric Department, Shaare Zedek Medical Center, Jerusalem, Israel.
Gerontology. 2007;53(3):121-4. doi: 10.1159/000097138. Epub 2006 Nov 17.
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of hyponatremia in elderly hospitalized patients; however in many patients the etiology remains unclear even after routine investigations.
To report our experience of the association of hyponatremia and urinary retention in elderly hospitalized patients.
Six patients with hyponatremia and urinary retention who were admitted to the geriatric department in our hospital during a four-year period (2001-2004).
The mean age of the patients was 85 years. The mean serum sodium level was 120 mEq/l, average volume of retained urine was 933 ml (range 500-1,500 ml). All patients underwent a comprehensive work-up seeking a possible cause for the hyponatremia. The diagnostic work-up was negative. In 5 of the patients the laboratory findings fulfilled the criteria for SIADH. In all patients hyponatremia resolved following urinary catheterization and fluid restriction. All patients made a complete recovery.
Potentially, urinary retention by itself may cause hyponatremia. The possible mechanism for this is SIADH, triggered by bladder distention or pain due to bladder distention. Urinary catheterization may be the key to treatment in these cases of hyponatremia.
抗利尿激素分泌异常综合征（SIADH）是老年住院患者低钠血症最常见的病因；然而，许多患者即使经过常规检查，病因仍不明确。
报告我们在老年住院患者中低钠血症与尿潴留相关性的经验。
在四年期间（2001 - 2004年）入住我院老年科的6例低钠血症合并尿潴留患者。
患者的平均年龄为85岁。平均血清钠水平为120 mEq/l，平均潴留尿量为933 ml（范围500 - 1500 ml）。所有患者均接受了全面检查以寻找低钠血症的可能病因。诊断性检查结果为阴性。5例患者的实验室检查结果符合SIADH标准。所有患者在导尿和限制液体摄入后低钠血症得到缓解。所有患者均完全康复。
尿潴留本身可能导致低钠血症。其可能机制是SIADH，由膀胱扩张或膀胱扩张引起的疼痛触发。在这些低钠血症病例中，导尿可能是治疗的关键。
