{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T23:10:39Z","timestamp":1652224239636},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Was ist neu?<\/jats:title><jats:p>\n          Pr\u00e4valenz und Bedeutung der Hyponatri\u00e4mie\u2002In der Allgemeinbev\u00f6lkerung findet sich eine Pr\u00e4valenz der milden, meist asymptomatischen Hyponatri\u00e4mie von 1,7\u20137,7\u200a%. Mit zunehmendem Alter steigt diese auf 11,6\u200a% bei den &gt;\u200a75-J\u00e4hrigen an. Wesentlich h\u00f6her liegt die Pr\u00e4valenz bei Altenheimbewohnern und Krankenhauspatienten. Die Hyponatri\u00e4mie stellt damit die h\u00e4ufigste Elektrolytst\u00f6rung im Alter dar.<\/jats:p><jats:p>\n          Pathopyhsiologie\u2002Pathophysiologisch liegt kein Natriummangel, sondern eine St\u00f6rung des Wasserhaushaltes zugrunde. Die Substitution von Natrium allein ist daher nicht zielf\u00fchrend, teils kontraindiziert. H\u00e4ufig verursachen Medikamente eine Hyponatri\u00e4mie.<\/jats:p><jats:p>\n          SIADH\u2002Aufgrund der multifaktoriellen Genese der Hyponatri\u00e4mie sollte bei allen Patienten eine Basisabkl\u00e4rung durchf\u00fchren, um ein SIADH (Syndrom der inad\u00e4quaten ADH-Sekretion) auszuschlie\u00dfen. Gerade im Alter findet man immer wieder F\u00e4lle eines intermittierenden SIADH.<\/jats:p><jats:p>\n          Die Abkl\u00e4rung\u2002F\u00fcr die Abkl\u00e4rung hat sich ein Algorithmus bew\u00e4hrt, der es in wenigen und einfachen Schritten erm\u00f6glicht, die Ursache zu erkennen und dabei gleichzeitig in die korrekten therapeutischen Schritte \u00fcberzuleiten.<\/jats:p><jats:p>\n          Grundlagen der Therapie\u2002Ziel muss ein Serumnatrium im Normbereich sein. Nur so lassen sich die Prognose und die Funktionalit\u00e4t der alten Patienten verbessern. F\u00fcr den SIADH haben wir mit Tolvaptan eine potente Substanz zur Verf\u00fcgung. Um die Gefahr einer \u00dcberkorrektur rechtzeitig erkennen zu k\u00f6nnen, sollte die Einstellung im station\u00e4ren Setting erfolgen.<\/jats:p>","DOI":"10.1055\/a-1643-6204","type":"journal-article","created":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T23:42:17Z","timestamp":1647387737000},"page":"301-305","source":"Crossref","is-referenced-by-count":0,"title":["Hyponatri\u00e4mie beim alten Patienten \u2013 Bedeutung, Abkl\u00e4rung und Therapie"],"prefix":"10.1055","volume":"147","author":[{"given":"Markus","family":"Gosch","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik f\u00fcr Geriatrie der Paracelsus Medizinischen Privatuniversit\u00e4t, N\u00fcrnberg"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,3,15]]},"reference":[{"issue":"08","key":"ref1","doi-asserted-by":"crossref","first-page":"1822","DOI":"10.1002\/jbmr.380","article-title":"Mild hyponatremia as a risk factor for fractures: the Rotterdam Study","volume":"26","author":"E J Hoorn","year":"2011","journal-title":"J Bone Miner Res"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"e88272","DOI":"10.1371\/journal.pone.0088272","article-title":"Prevalence, incidence and etiology of hyponatremia in elderly patients with fragility fractures","volume":"9","author":"K Cumming","year":"2014","journal-title":"PLoS One"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"e0194379","DOI":"10.1371\/journal.pone.0194379","article-title":"Low serum sodium levels at hospital admission: Outcomes among 2.3 million hospitalized patients","volume":"13","author":"S Al Mawed","year":"2018","journal-title":"PLoS One"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.2147\/CIA.S138535","article-title":"Hyponatremia in the elderly: challenges and solutions","volume":"12","author":"T D Filippatos","year":"2017","journal-title":"Clin Interv Aging"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1093\/ageing\/afab064","article-title":"Hyponatraemia in older people is usually multifactorial and commonly iatrogenic","volume":"50","author":"R L Soiza","year":"2021","journal-title":"Age Ageing"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1093\/ageing\/afaa248","article-title":"Active management of hyponatraemia and mortality in older hospitalised patients compared with younger patients: results of a prospective cohort study","volume":"50","author":"O Thorpe","year":"2021","journal-title":"Age Ageing"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1038\/ki.2015.4","article-title":"Current treatment practice and outcomes. 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