{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:45:27Z","timestamp":1786373127186,"version":"build-2736575974"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Hyponatremia is the most common electrolyte disorder. With the aging of the population and the greater propensity of the elderly to develop hyponatremia, this electrolyte disorder is of increasing importance to the practicing nephrologist. In this Attending Rounds, an illustrative patient with hyponatremia is presented. The reasons for the increased incidence and prevalence of hyponatremia in the elderly are discussed, with emphasis on the effects of aging on urinary dilution, the frequently multifactorial nature of hyponatremia in this population, and the absence of a definite cause for inappropriate and persistent vasopressin release in many such patients. The rationale for treating the hyponatremia, even when apparently asymptomatic, is discussed, with attention to cognitive function, gait, and bone structure disturbances that increase the risk for fractures. The various available treatment approaches, including water restriction, demeclocycline, loop diuretics with NaCl supplementation, urea, and vasopressin antagonists are summarized, with emphasis on the efficacy and limitations of each of these therapies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.03100312","type":"journal-article","created":{"date-parts":[[2012,10,4]],"date-time":"2012-10-04T23:06:12Z","timestamp":1349391972000},"page":"469-475","source":"Crossref","is-referenced-by-count":17,"title":["An Elderly Patient with Chronic Hyponatremia"],"prefix":"10.2215","volume":"8","author":[{"given":"Tomas","family":"Berl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-19-20230811","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1136\/hrt.35.5.527","article-title":"Effect of posture on blood pressure in the elderly.","volume":"35","author":"Caird","year":"1973","journal-title":"Br Heart J"},{"key":"R2-19-20230811","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1111\/j.1532-5415.1979.tb06439.x","article-title":"Hyponatremia as observed in a chronic disease facility.","volume":"27","author":"Kleinfeld","year":"1979","journal-title":"J Am Geriatr Soc"},{"key":"R3-19-20230811","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1111\/j.1532-5415.1995.tb06623.x","article-title":"Hyponatremia in a nursing home population.","volume":"43","author":"Miller","year":"1995","journal-title":"J Am Geriatr Soc"},{"key":"R5-19-20230811","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.cccn.2003.08.001","article-title":"Age and gender as risk factors for hyponatremia and hypernatremia.","volume":"337","author":"Hawkins","year":"2003","journal-title":"Clin Chim Acta"},{"key":"R6-19-20230811","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1681\/ASN.V541106","article-title":"Increased susceptibility to thiazide-induced hyponatremia in the elderly.","volume":"5","author":"Clark","year":"1994","journal-title":"J Am Soc Nephrol"},{"key":"R7-19-20230811","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1038\/sj.ki.5000076","article-title":"Renal ENaC subunit, Na-K-2Cl and Na-Cl cotransporter abundances in aged, water-restricted F344 x Brown Norway rats.","volume":"69","author":"Tian","year":"2006","journal-title":"Kidney Int"},{"key":"R8-19-20230811","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1093\/qjmed\/hcl071","article-title":"Severe hyponatraemia in medical in-patients: Aetiology, assessment and outcome.","volume":"99","author":"Clayton","year":"2006","journal-title":"QJM"},{"key":"R9-19-20230811","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/S0002-9343(97)00250-7","article-title":"The syndrome of inappropriate antidiuretic hormone secretion in the elderly.","volume":"103","author":"Hirshberg","year":"1997","journal-title":"Am J Med"},{"key":"R10-19-20230811","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1017\/S1740925X11000093","article-title":"Roles of glutamine in neurotransmission.","volume":"6","author":"Albrecht","year":"2010","journal-title":"Neuron Glia Biol"},{"key":"R13-19-20230811","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1093\/qjmed\/hcn061","article-title":"Mild hyponatremia and risk of fracture in the ambulatory elderly.","volume":"101","author":"Gankam Kengne","year":"2008","journal-title":"QJM"},{"key":"R14-19-20230811","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1007\/s11255-009-9585-2","article-title":"Hyponatremia associated with large-bone fracture in elderly patients.","volume":"41","author":"Sandhu","year":"2009","journal-title":"Int Urol Nephrol"},{"key":"R15-19-20230811","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":"Hoorn","year":"2011","journal-title":"J Bone Miner Res"},{"key":"R16-19-20230811","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1359\/jbmr.090827","article-title":"Hyponatremia-induced osteoporosis.","volume":"25","author":"Verbalis","year":"2010","journal-title":"J Bone Miner Res"},{"key":"R19-19-20230811","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1038\/ki.1974.37","article-title":"Effects of demethylchlortetracycline on cellular action of antidiuretic hormone in vitro.","volume":"5","author":"Dousa","year":"1974","journal-title":"Kidney Int"},{"key":"R20-19-20230811","doi-asserted-by":"crossref","first-page":"2513","DOI":"10.1001\/jama.1980.03300500039026","article-title":"Plasma demeclocycline levels and nephrotoxicity. 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