Division of Nephrology, Department of Internal Medicine, Muş State Hospital, Muş, Turkey.
The Cambridge Centre for Sport and Exercise Science, Anglia Ruskin University, Cambridge, UK.
Int Urol Nephrol. 2021 Oct;53(10):2089-2098. doi: 10.1007/s11255-021-02789-8. Epub 2021 Feb 18.
The impact of mild hyponatremia on geriatric syndromes is not clear. Our aim was to determine associations between mild hyponatremia and results of comprehensive geriatric assessment tools in outpatient settings.
We reviewed medical records of 1255 consecutive outpatient elderly subjects and compared results of comprehensive geriatric assessment measures among patients with mild hyponatremia (serum Na 130-135 mEq/L) versus normonatremia (serum Na 136-145 mEq/L). The comprehensive geriatric assessment measures included the Basic and Instrumental Activities of Daily Living, Mini Mental State Examination, Geriatric Depression Score, Tinetti Mobility Test, the Timed Up&Go Test, the Mini Nutritional Assessment, the handgrip test, the Insomnia Severity Index, polypharmacy, recurrent falls, urinary incontinence, orthostatic hypotension, and nocturia.
Of the 1255 patients, 855 were female (68.1%), and the mean age was 73.7 ± 8.3 years. Mild hyponatremia was detected in 108 patients (8.6%). The median serum sodium was 140.5 [interquartile range (IQR) 138.4-141.8] versus 133.8 [IQR, 132.3-134.2] in normonatremia and mild hyponatremia groups, respectively (p < 0.001). The only significant difference for comorbidities between normonatremia and mild hyponatremia groups was the frequency of hypertension (66.9% versus 76.7%, respectively (p = 0.041). None of the comprehensive geriatric assessment tools conferred a significant association with mild hyponatremia. Of the 1061 subjects with available survival data, 96 (9.0%) deceased within 3-4 years of follow-up (p = 0.742). Hyponatremia as an independent variable did not have a significant effect on mortality in univariate logistic regression analysis (OR 1.13, 95% CI 0.55-2.33, p = 0.742).
Mild hyponatremia does not apparently affect results of geriatric assessments significantly. Whether particular causes of hyponatremia may have different impacts should be tested in further studies.
轻度低钠血症对老年综合征的影响尚不清楚。我们的目的是确定在门诊环境中，轻度低钠血症与综合老年评估工具结果之间的关系。
我们回顾了 1255 例连续门诊老年患者的病历，并比较了轻度低钠血症（血清 Na 130-135 mEq/L）与正常钠血症（血清 Na 136-145 mEq/L）患者的综合老年评估措施结果。综合老年评估措施包括基本和工具性日常生活活动、简易精神状态检查、老年抑郁评分、Tinetti 活动能力测试、起立行走计时测试、迷你营养评估、握力测试、失眠严重程度指数、多种药物治疗、反复跌倒、尿失禁、体位性低血压和夜尿症。
在 1255 例患者中，855 例为女性（68.1%），平均年龄为 73.7±8.3 岁。108 例（8.6%）患者存在轻度低钠血症。血清钠中位数分别为轻度低钠血症组 140.5 [四分位距（IQR）138.4-141.8] 和正常钠血症组 133.8 [IQR，132.3-134.2]（p<0.001）。正常钠血症组和轻度低钠血症组之间仅在合并症的高血压频率方面存在显著差异（分别为 66.9%和 76.7%（p=0.041）。在综合老年评估工具中，没有一项与轻度低钠血症有显著相关性。在有可用生存数据的 1061 例患者中，96 例（9.0%）在 3-4 年随访期间死亡（p=0.742）。在单变量逻辑回归分析中，低钠血症作为独立变量对死亡率无显著影响（OR 1.13，95%CI 0.55-2.33，p=0.742）。
轻度低钠血症对老年评估结果的影响并不明显。是否特定的低钠血症原因可能有不同的影响，需要在进一步的研究中进行检验。
