Age-related variety in electrolyte levels and prevalence of dysnatremias and dyskalemias in patients presenting to the emergency department.
BACKGROUND
It was found that age and female gender are predisposing factors for hyponatremia in patients taking thiazides.


OBJECTIVE
To investigate whether a relationship exists between age and gender and serum sodium and potassium as well as the prevalence rates in a large population of patients presenting to the emergency department of a university hospital.


METHODS
In this retrospective analysis we gathered data on age, gender and current diuretic medication of all patients admitted to the emergency department of a large university hospital with measurement of serum sodium and potassium between January 1, 2009 and December 31, 2010. Prevalence rates of and risk factors for electrolyte disorders were calculated on the basis of these data.


RESULTS
A total of 20,667 patients were included in the analysis. Serum sodium levels declined significantly with increasing age while serum potassium rose, independent of diuretic medication at presentation. The prevalence rates of hyponatremia and hyperkalemia increased from 2.3% for hyponatremia in patients aged 16-21 years to 16.9% in patients aged >80 years and from 0.8% for hyperkalemia to 10.4%. In the regression analysis, age >60 years was a predictor for the presence of hyponatremia and hyperkalemia as was current use of diuretic medication. Male gender was associated with a decreased prevalence of hyponatremia and hypokalemia, while it was a predictor of hyperkalemia.


CONCLUSIONS
Sodium levels were lower with increasing age, independent of diuretic intake, while potassium levels were higher. We found dramatically increasing prevalences of hyponatremia and hyperkalemia with increasing age, while no such effect could be found for hypernatremia and hypokalemia.
Department of Emergency Medicine, Inselspital, University Hospital Bern, Bern, Switzerland.
Gregor
G
Lindner
Carmen A
CA
Pfortmüller
Alexander B
AB
Leichtle
Georg M
GM
Fiedler
Aristomenis K
AK
Exadaktylos
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood*; D004232:Diuretics / Q000009:adverse effects; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D007010:Hyponatremia / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012964:Sodium / Q000097:blood*; D013557:Switzerland / Q000453:epidemiology; D014883:Water-Electrolyte Imbalance / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
D004232:Diuretics; D012964:Sodium; D011188:Potassium