Hyponatremia May Up Risk of Fracture
Last Updated: 2010-02-03 17:00:02 -0400 (Reuters Health)
"This observation is most likely explained by recent evidence suggesting that mild hyponatremia may be associated with disorders of balance and gait and with a resultant increased risk of falls," co-author Dr. Joseph A. Eustace told Reuters Health in an email.
Dr. Eustace and his colleagues from
Their study included 1408 consecutive women who had bone mineral density and laboratory tests done between September 2006 and April 2007. Self-reports of fracture were confirmed by radiology reports and/or fracture clinic records.
The mean serum sodium was 140.6 mmol/L. Overall, 59 subjects (4.2%) had hyponatremia (sodium < 135 mmol/L), 634 (45%) had osteoporosis, and 254 (18.0%) had at least one prior fracture.
The incidence of hyponatremia was 8.7% in women with fractures versus 3.2% in those without (p < 0.001). On multivariate analysis, hyponatremia was significantly and independently associated with fracture occurrences (odds ratio 2.25; p < 0.01).
While mild hyponatremia is a fairly common finding, especially in the elderly, it is one that is often ignored. "If confirmed, our findings would suggest that greater attention be paid to the detection and treatment of hyponatremia, especially in individuals with a high risk of falling," Dr. Eustace said.
"In addition, as hyponatremia is often iatrogenic and in particular is associated with the use of thiazide type diuretics or with selective serotonin reuptake inhibitors (SSRI), it should be actively screened for following the initiation of such therapy, and if detected, the risk-to-benefit ratio of continuing the medication in the context of the individual patient should be re-evaluated," he noted.
Clin J Am Soc Nephrol 2010.
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