ALTERAZIONI DEL METABOLISMO DEL SODIO NELL’ANZIANO: CASISTICA DI UN REPARTO DI GERIATRIA PER ACUTI

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Abstract

[automatically translated] Premise. Alterations in plasma sodium concentration are the most frequent electrolyte disturbances in hospitalized patients and the incidence and prevalence increases with age. The aging is an independent risk factor and very significant for the alterations of the budget of sodium and water. There are numerous factors that cooperate in increasing susceptibility to the elderly such imbalances, depending on age related physiological changes of the mechanisms that regulate the body's water-salt balance sheet, from the progressive reduction of the compensation capacity that characterizes the phenomenon of the same 'aging and the comorbidities, typical of the geriatric patient, which will further aggravate the already compromised body's coping mechanisms. These conditions are associated with other factors related to the above, such as cognitive impairment, the reduction in thirst, loss of autonomy and in the contribution of water and food self-sufficiency. The severity of the plasma concentration of sodium alterations could be often light and reflection of the elderly patient's fragility and constitute a further problem that complicates even more difficult geriatric patient management, in which most often associated diseases and a large number of drugs that direct or indirect influence on the regulation of sodium and water lens. The main objective of the study was to define the prevalence of hyponatraemia and dell'ipernatremia in a population of elderly patients older than 65 years, admitted to a geriatrics department for Treble (21:01 UO Geriatrics - UNIVERSITY 'OF PALERMO STUDIES) examining patients admitted in 2010-2011. In addition, the study aimed to analyze the distribution of the frequency of changes in serum sodium in both sexes, in different age groups (65-74, 75-84,> = 85) and severity levels, the entrance and during the recovery. Finally, it was analyzed the seasonal pattern of the two disorders natremia and evaluate evaluated the association with other diseases and pathological conditions, with some commonly used drugs and the correlation with alterations of the other main electrolytes (K +, Ca ++, Cl-, mg ++, P) with respect to a control sample, consisting of eunatremici subjects. Results. Of the 383 patients hospitalized in the period under review, 211 have reported alterations in plasma sodium concentration (55.1%). Hyponatremia has been reported in 110 patients and hypernatremia in 101, when it considers a minimum period of one day. The first was more frequent at the entrance, while the second during hospitalization. The distribution in both sexes was similar. Dividing the sample into three age groups (65-74, 75-84,> = 85) showed a higher prevalence of both alterations in the intermediate band. Taking into consideration the seasonal pattern seen that hyponatremia has a greater frequency in autumn and winter, while the hypernatremia in summer and winter. Hypernatremia during the summer season is significantly more frequent than all'iponatremia (p <0.001), vice versa in autumn is observed the opposite (p <0.001). For both imbalances was observed a significant association with mental status changes (p <0.001) than subjects eunatremici, with the other dis-Ionian (p <0.001), hypoalbuminemia (p <0.001) and fever (p <0.05). Finally the hypernatremia is significantly associated with infusion therapy (p <0.01), parenteral nutrition (p <0.01) and the use of albumin (p <0.05) and intravenous antibiotics (p < 0.001), conditions that indicate greater severity of clinical conditions and comorbidity of these pat
Original languageItalian
Pages (from-to)420-420
Number of pages1
JournalGIORNALE DI GERONTOLOGIA
Volume62
Publication statusPublished - 2014

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