Why Do Elderly People Lack Sodium?

Update Date: 2024-05-20 Source: Network

Causes and Treatment of Sodium Deficiency in the Elderly

Sodium is a crucial element. Like other trace elements, the amount required in the body is small, but its absence can have significant impacts on the body. There are many reasons for sodium deficiency in the elderly. Their bodies are not in good condition, and when this occurs, it is essential to identify the causes as soon as possible and take targeted measures. So, what are the reasons for sodium deficiency in the elderly? Let's take a look.

Causes of Sodium Deficiency in the Elderly

There are several considerations for the causes of low sodium in the elderly, which may be related to the use of certain medications. For example, when diuretics and dehydrating agents are used, sodium ions can be lost in large quantities. As the volume of urine increases, a significant amount of sodium is excreted with the urine. Diseases such as aldosteronism, diabetes, vomiting, diarrhea, extensive burns, hypothyroidism, and adrenal cortical dysfunction can also lead to symptoms of low sodium. Additionally, physiological factors can contribute to low sodium levels, including inadequate water intake or a long-term low-salt diet, which can lead to malnutrition and symptoms of low sodium.

Management of Sodium Deficiency in the Elderly

1. Conventional Treatment: Traditional methods for treating dilutional hyponatremia include treating the underlying disease, water restriction, administration of hypertonic saline (3%-5% sodium chloride at 2-3ml/kg, 100ml/h for 1-2 hours) for sodium replacement, diuretics, dehydration, dexamethasone (to supplement adrenal cortical hormones), and demeclocycline (which inhibits the effect of ADH on the renal tubules and promotes water excretion). Administering hypertonic saline appropriately can maintain blood sodium levels, and combining it with diuretics is a safe and effective method to improve the short-term prognosis of CHF. In elderly patients with CHF complicated by hyponatremia, the addition of lisinopril at a dosage of 5-10mg daily for 2 weeks on the basis of conventional treatment is safe and effective.

2. Iatrogenic Diseases Caused by Sodium Replacement: Excessive sodium supplementation or rapid intravenous infusion can lead to acute heart failure. Elderly individuals have decreased cardiac function and insufficient compensatory mechanisms, making them more susceptible to heart failure. Rapid correction of hyponatremia can also cause central pontine myelinolysis, a rare acute demyelinating lesion at the base of the pons, typically manifesting as pseudobulbar palsy and spastic paralysis of the limbs. MRI is currently the most effective diagnostic method for this condition. There is no specific treatment for this disease, and active treatment of the underlying disease, along with supportive and symptomatic management, is recommended.

3. Latest Treatment Advances: Arginine vasopressin receptor antagonists work by blocking arginine vasopressin (AVP), increasing the excretion of purified water (non-solute water), and elevating plasma osmolality. They have been approved by the US Food and Drug Administration for the treatment of dilutional hyponatremia. Clinical observations in patients with refractory heart failure and hyponatremia have shown promising results. In a study of 23 patients, divided into two groups (group A with 12 patients with systolic blood pressure >140mmHg and group B with 11 patients), treatment with arginine vasopressin receptor antagonists demonstrated significant improvements in blood pressure and sodium levels.