Clinical features of geriatric patients with drug-induced hyponatremia

AIM: Hyponatremia is the most common electrolyte disorder in adults. One of the most common causes of hyponatremia is medication. Data on the clinical findings of geriatric patients with drug-induced hyponatremia are limited. The aim of this study was to investigate the demographic, clinical, laboratory, and pharmacological characteristics of geriatric patients with drug-induced hyponatremia and to determine any possible differences compared to non-geriatric patients. MATERIALS AND METHODS: This retrospective study included 103 adult patients admitted to the Internal Medicine Department of Sakarya Training and Research Hospital between 2021 and 2024 with a diagnosis of drug-induced hyponatremia. Patients were divided into two groups: geriatric (n=67) and nongeriatric (n=36). Demographic, clinical, laboratory, and medication data related to hyponatremia were recorded and compared between groups. RESULTS: The most common medications causing hyponatremia in patients were thiazides, angiotensin receptor blocker + thiazide combination, and antidepressants, in that order, with no significant difference between groups. The incidence of hyponatremia associated with antipsychotic and antiepileptic drugs was significantly higher in non-geriatric patients than in geriatric patients (p=0.049 and p=0.031, respectively). The incidence of hypertension and coronary artery disease was significantly higher in geriatric patients than in non-geriatric patients, while epilepsy and schizophrenia diagnoses were significantly more common in non-geriatric patients (all p<0.05). The most common symptoms and findings associated with hyponatremia were loss of appetite, nausea, and vomiting, and there was no significant difference between the groups. In addition, there was no significant difference between geriatric and non-geriatric patients in terms of biochemical and hemogram parameters, except for uric acid levels. Uric acid levels were significantly higher in geriatric patients (p=0.020). CONCLUSION: The most common drugs causing hyponatremia in geriatric patients with drug-induced hyponatremia are thiazides, angiotensin receptor blocker+thiazide combinations, and antidepressants, in that order. The incidence of hyponatremia associated with antipsychotic and antiepileptic drugs is significantly higher in nongeriatric patients than in geriatric patients. There is no significant difference in biochemical and hematological parameters between geriatric and non-geriatric patients with drug-induced hyponatremia. Keywords: Antidepressants, geriatric, hyponatremia, thiazides