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
Received | 09/06/2017 |
Accepted for pubblication | 23/06/2017 |
Published | Jun. 2017 |
Review by | Single-blind |
ABSTRACT
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.