Abstract: SA-PO711
Impact of Effective Treatment of Hyponatremia in Geriatric Patients
Session Information
- Geriatric Nephrology
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Geriatric Nephrology
- 1100 Geriatric Nephrology
Authors
- Burst, Volker Rolf, Department 2 of Internal Medicine, Renal Division; University of Cologne, Cologne, Germany
- Grundmann, Franziska, University of Cologne, Cologne, Germany
- Suárez, Victor, University Hospital of Cologne, Koeln, Germany
- Todorova, Polina, University Hospital Cologne, Cologne, Germany
- Brinkkoetter, Paul T., University Hospital Cologne, Cologne, Germany
Background
Hyponatremia is highly prevalent in old age and associated with increased morbidity and mortality. Until now it is not known whether effective treatment of frequently perceived asymptomatic hyponatremia in the geriatric population has an impact on patient outcome. Here, we investigate the effect of inpatient treatment of patients with hypotonic hyponatremia on neurocognitive and motor performance using a comprehensive geriatric assessment (CGA).
Methods
150 geriatric patients with serum [Na+] <130 mEq/L on admission and complete diagnostic datasets were enrolled. The results of the CGA on admission as well as the change of individual CGA tests until discharge were compared to a matched (sex, age, Barthel index of activities of daily living [ADL]) control group.
Results
Both groups were similar with respect to comorbidities and clinical characteristics. There were no differences in the individual assessments (ADL, Tinetti’s Mobility Assessment, Timed Up and Go-Test, Mini-Mental State Examination [MMSE], handgrip strength, Geriatric Depression Scale, Clock-drawing Test, and Esslinger Transfer Scale) at baseline (i.e. upon admission). A small but highly significant improvement as compared to the control group between baseline and time of discharge was observed with regard to ADL (mean(SD): 14.3(17.12)] vs. 9.84(14.67); P=0.002) and MMSE (mean(SD): 1.43(3.71) vs. 0.72(2.17); P=0.002) in the primary analysis group and this improvement was attributable to those patients in which serum [Na+] was increased by >5 mEq/L whereas no improvement was seen in those in which serum [Na+] was increased by only ≤5 mEq/L. However, regression analyses were not able to confirm a statistically significant association between effective [Na+] increase and CGA outcome within the primary analysis group. With respect to the subgroup of euvolemic hyponatremia, only changes of MMSE results were significantly different.
Conclusion
With the most robust changes observed with ADL and MMSE, the results of this prospective observational study suggest a true impact of treating hyponatremia on quality of life and neurocognitive function. However, the detected differences are small and further investigations are needed to prove their clinical relevance.
Funding
- Commercial Support – Otsuka