title: Filling the Gap - Improving Awareness and Practice in Hyponatraemia and the Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) in the Older Patient: A European Consensus View.
abstract: Introduction:Causes of hyponatraemia in older patients are multivariate and in the case of SIADH may often be drug induced. Diagnostic and treatment algorithms are unclear for this important age group.Methods:The author group identified 6 broad themes for consensus and formulated 42 separate consensus statements within these 6 themes. Statements were then circulated to geriatricians, general practitioners and other doctors to test agreement at the European level.Results:64 responses were evaluated from around Europe. Agreement was achieved in 86% of the statements following amendment and redistribution of 6 of the statements. The survey and its feedback prompted the development of 13 recommendations related to the diagnosis and treatment of hyponatraemia including SIADH.Conclusion:The series of 13 recommendations developed here is intended to increase clarity for clinicians managing older patients with hyponatraemia and SIADH. Surprisingly, despite the lack of clear guidelines or recommendations for this age group consensus levels for the author-based statements were high among the respondents.
authors.affiliation: Department of Clinical Pharmacology, Center for Geriatric Pharmacology in Mannheim.
authors.forename: M
authors.initials: M
authors.lastname: Wehling
authors.affiliation: South Warwickshire NHS Foundation Trust, Warwick, UK.
authors.forename: C
authors.initials: C
authors.lastname: Ashton
authors.affiliation: Lewisham and Greenwich NHS Trust, London, UK.
authors.forename: E
authors.initials: E
authors.lastname: Ekpo
authors.affiliation: SG Market Access Ltd, Chichester, UK.
authors.forename: S
authors.initials: S
authors.lastname: Gwynn
authors.affiliation: Department of Nephrology, Lyon Sud University Hospital, Pierre Benite, France.
authors.forename: M
authors.initials: M
authors.lastname: Laville
authors.affiliation: Lund University, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Olsson
authors.affiliation: Kingston Hospital, NHS Foumdation Trust, Kingston, UK.
authors.forename: M
authors.initials: M
authors.lastname: Spring
mesh_terms: D000367:Age Factors; D003697:Delphi Technique; D003937:Diagnosis, Differential; D005060:Europe; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D007177:Inappropriate ADH Syndrome / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D011237:Predictive Value of Tests; D000071836:Professional Practice Gaps; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome