L'IMPORTANZA DELL'IPONATREMIA IN ONCOLOGIA GERIATRICA
R. Berardi, T. Melatani, I. Fiordoliva, G. Baleani, A. Savini
Vol.2 (2017), issue 2, pag. 21-31
|Accepted for pubblication||23/06/2017|
The risk of cancer increases with age and life expectancy. In elderly cancer patients hyponatremia is the most common electrolyte disorder, it can be associated to the use of drugs i.e. diuretics and non steroidal anti-inflammatory drugs (NSAIDs), endocrinopathies, vomiting and nausea, heart failure, cirrhosis or often syndrome of inappropriate antidiuretic hormone. Hyponatremia in frail cancer patients is related with worsening of performance status and quality of life, prolonged hospitalization, delays in scheduled chemotherapy and reduced survival. In elderly cancer patient with hyponatremia disorder the main symptoms are the incidence of accidental fall and bone fractures increases. This electrolytic disorder must be considered and corrected in elderly cancer patients who develop sudden cognitive deterioration, accidental falls, severe incontinence, convulsions or coma. Hyponatremia needs an early correction and the treatment depends on the severity and the onset of sodium serum reduction, extracellular fluid volume and etiology. Treatment options include fluids restriction, hypertonic saline, loop diuretics, isotonic saline, Tolvaptan, Demeclocycline, Urea, Lithium Carbonate. The aim of this review is to analyze the role of hyponatremia in elderly cancer patients, evaluating causes, diagnosis, management and clinical implications.