Kinoshita Azuna, Yonemitsu Takafumi, Miyai Nobuyuki, Yonemitsu Akira
Graduate School of Health and Nursing Science Wakayama Medical University Wakayama Japan.
Department of Emergency and Critical Care Medicine Wakayama Medical University Wakayama Japan.
J Gen Fam Med. 2025 Jan 10;26(3):205-212. doi: 10.1002/jgf2.767. eCollection 2025 May.
Hypertonic dehydration is common among older adults and is associated with increased mortality and the incidence of several diseases, such as renal failure and cardiovascular complications. Herein, we aimed to statistically identify risk factors for hypertonic dehydration in older adults in Japan.
This cross-sectional study included outpatients aged ≥65 years who visited an internal medicine clinic between March and November 2021. Hypertonic dehydration was determined using serum osmolality (≥300 mOsm/kg) calculated from blood sodium, urea nitrogen, and glucose levels. The body composition of each participant was estimated using bioelectrical impedance analysis. The participants were instructed to record their fluid intake for two consecutive days. We conducted multivariate analysis to examine factors associated with hypertonic dehydration.
In total, 104 participants (male: 32.7%, mean: 76.6 years) were enrolled. The prevalence of hypertonic dehydration among study participants was 30.8%. After adjusting for potential confounding factors, the daily fluid intake per body weight, body mass index, body fat percentage, diabetes mellitus, and number of medications were significantly associated with hypertonic dehydration. Odds ratios for hypertonic dehydration were 5.47 for daily fluid intake per body weight <20 mL/kg/day (vs. ≥30 mL/kg/day), 2.55 for body mass index ≥25 kg/m (vs. <25 kg/m), and 3.66 for number of medications ≥10 (vs. <6). The area under the receiver operating characteristic curve was 0.712 (95% confidence interval, 0.6060.817; = 0.001).
Decreased fluid intake, obesity, diabetes mellitus, and polypharmacy were independently associated with hypertonic dehydration in older Japanese outpatients.
高渗性脱水在老年人中很常见，并且与死亡率增加以及多种疾病的发病率相关，如肾衰竭和心血管并发症。在此，我们旨在通过统计学方法确定日本老年人高渗性脱水的危险因素。
这项横断面研究纳入了2021年3月至11月期间到内科门诊就诊的65岁及以上门诊患者。高渗性脱水通过根据血钠、尿素氮和血糖水平计算的血清渗透压（≥300 mOsm/kg）来确定。使用生物电阻抗分析估算每位参与者的身体成分。参与者被要求连续两天记录他们的液体摄入量。我们进行多变量分析以检查与高渗性脱水相关的因素。
总共招募了104名参与者（男性：32.7%，平均年龄：76.6岁）。研究参与者中高渗性脱水的患病率为30.8%。在调整潜在混杂因素后，每体重每日液体摄入量、体重指数、体脂百分比、糖尿病和用药数量与高渗性脱水显著相关。每体重每日液体摄入量<20 mL/kg/天（对比≥30 mL/kg/天）时高渗性脱水的比值比为5.47，体重指数≥25 kg/m²（对比<25 kg/m²）时为2.55，用药数量≥10种（对比<6种）时为3.66。受试者工作特征曲线下面积为0.712（95%置信区间，0.606 - 0.817；P = 0.001）。
液体摄入量减少、肥胖、糖尿病和多重用药与日本老年门诊患者的高渗性脱水独立相关。
