title: [Severe osteoporosis - the story of chronic medication-related hyponatremia].
abstract: The authors present a case-report of a 73 years old woman treated for arterial hypertension within past 15 years with diuretics (thiazides, amiloride and indapamide) and concomitantly with antidepressive trazodone. The patient developed severe osteoporosis after 6 years of such a treatment with multiple fractures even after minor trauma; during whole this period severe hyponatremia without adequate supplementation was documented. Most probably, there exists tight relationship of osteoporosis and hyponatremia in this patient - the authors discuss possible pathophysiological mechanisms at the level of renal tubules, osteoblasts and osteoclasts, hypopituitary-skeletal axis, syndrome of inadequate adiuretin secretion (SIADH) and possible influence of acid-base balance disturbances.
authors.forename: Pavel
authors.initials: P
authors.lastname: Polák
authors.forename: Petr
authors.initials: P
authors.lastname: Husa
authors.forename: Hana Matějovská
authors.initials: HM
authors.lastname: Kubešová
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D004232:Diuretics / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007010:Hyponatremia / Q000139:chemically induced*; D010024:Osteoporosis / Q000188:drug therapy*
chemical_list: D000928:Antidepressive Agents; D004232:Diuretics