Skip to main content
SpringerLink
Log in
Book cover

Diseases in the Elderly pp 263–273Cite as

Electrolyte Disturbances and Disorders of Mineral Metabolism in the Elderly

  • Chapter
  • First Online:

  • 2118 Accesses

Abstract

With normal ageing physiological alterations in water and sodium regulation and associated changes in the renal and hormonal systems may contribute to relative frequency of water and electrolyte disorders. In the elderly glomerular filtration rate falls and water homeostasis falls due to decrease in thirst sensation. Water homeostasis falls due to the thirst sensation decreasing with age. Hence the ability to withstand disease-related environmental stress or iatrogenic stress becomes increasingly narrowed in the elderly. Dehydration is a frequent cause of morbidity and mortality in the elderly. The hormones aldosterone, antidiuretic hormone (ADH) and atrial natriuretic peptide (ANP) regulate the fluid and electrolyte balance and partly control the changes in fluid balance in the elderly. Disturbances of potassium homeostasis present as low or high serum potassium and are common among hospitalised patients. The metabolism of calcium and vitamin D is altered in a number of ways by ageing.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

Anatomical and Physiological Age-Related Changes-Mineral Metabolism

  1. Miller M. Hyponatraemia in the elderly: risk factors clinical consequences and management. Clin Geriatrics. 2009;17(9):34–9.

    Google Scholar 

  2. Miller M. Fluid and electrolyte homeostasis in the elderly: physiological changes of ageing and clinical consequences. Bailleres Clin Endocrinol Metab. 1999;7:367–87.

    Google Scholar 

  3. Luckey AE, Parsa CJ. Fluid and electrolytes in the aged. Arch Surg. 2003;138:1055–60.

    Article  PubMed  Google Scholar 

  4. Phillips PA, Rolls BJ, Ledingham JG, Forsling ML, Morton JJ, Wollner L, et al. Reduced thirst after water deprivation in healthy elderly men. N Engl J Med. 1984;311:753–9.

    Article  CAS  PubMed  Google Scholar 

  5. Kumar R. Metabolism of 1,25-dihydroxyvitamin D3. Physiol Rev. 1984;64(2):478–504 (abstract).

    CAS  PubMed  Google Scholar 

  6. Janssen HCJP, Samson MM, Verhear MJJ. Vitamin deficiency, muscle function and falls in the elderly people. Am J Clin Nutr. 2002;75(4):611–5.

    CAS  PubMed  Google Scholar 

  7. Ferry M. Strategies for ensuring good hydration in the elderly. Nutr Rev. 2005;63(6 Pt 2):S22–9 (abstract).

    Article  PubMed  Google Scholar 

Disorders of Sodium

  1. Miller M, Morley JE, Rubenstein LZ. Hyponatraemia in a nursing home population. J Am Geriatr Soc. 1995;43:1410–3.

    Article  CAS  PubMed  Google Scholar 

  2. Sunderam SG, Mankikar GD. Hyponatraemia in the elderly. Age Ageing. 1983;12:77–80.

    Article  CAS  PubMed  Google Scholar 

  3. Luckey AE, Parsa CJ. Fluid and electrolytes in the ages. Arch Surg. 2003;138:1055–60.

    Article  PubMed  Google Scholar 

  4. Ohashi M, Fujo N, Nawata H, Kato K, Ibayashi H, Kangawa K, et al. High plasma concentrations of human atrial natriuretic polypeptide in aged man. J Clin Endocrinol Metab. 1987;64:81–5.

    Article  CAS  PubMed  Google Scholar 

  5. Biswas M, Des JS. Hyponatraemia in clinical practice. Postgrad Med J. 2007;83(280):373–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Miller M. Hyponatraemia in the elderly. Risk factors clinical consequences and management. Clin Geriatr. 2009;17(9):34–9.

    Google Scholar 

  7. Goh KP. Management of hyponatraemia. Am Fam Physician. 2004;69:2387–94 (abstract).

    PubMed  Google Scholar 

  8. Kunhle U, Lewicki S, Fuller PJ. Endocrine disorders of sodium regulation. Horm Res. 2004;61(2):68–83.

    Article  Google Scholar 

  9. Bartter FC, Schwartz WB. The syndrome of inappropriate secretion of anti-diuretic hormone. Am J Med. 1967;42:790–806.

    Article  CAS  PubMed  Google Scholar 

  10. Ditzel J. Hyponatraemia in an elderly woman and inappropriate secretion on antidiuretic hormone. Acta Med Scand. 1966;179:407–16.

    Article  CAS  PubMed  Google Scholar 

  11. Crowe M. Hyponatraemia due syndrome of inappropriate antidiuretic hormone secretion in the elderly. Ir Med J. 1980;73:482–3.

    CAS  PubMed  Google Scholar 

  12. Hirshberg B, Ben-Yehuda A. The syndrome of inappropriate antidiuretic hormone secretion in the elderly. Am J Med. 1997;103:270–3.

    Article  CAS  PubMed  Google Scholar 

  13. Palm C, Reiman D, Gross P. Hyponatraemia-with comments on hypernatraemia. Ther Umsch. 2000;57(6):400–7 (abstract).

    Article  CAS  PubMed  Google Scholar 

  14. Laczi F. Etiology, diagnostics, and therapy of hyponatraemia. Orv Hetil. 2008;149(29):1347–54 (abstract).

    Article  PubMed  Google Scholar 

  15. Weisberg LP. Pseudohyponatraemia: a reappraisal. Am J Med. 1989;86(3):315–8 (abstract).

    Article  CAS  PubMed  Google Scholar 

  16. Aw TC, Kiechie FL. Pseudohyponatraemia. Am J Emerg Med. 1985;3(3):236–9 (abstract).

    Article  CAS  PubMed  Google Scholar 

  17. Palevsky PM, Bhagra R, Greenberg A. Hypernatraemia in hospitalised patients. Ann Intern Med. 1996;124(2):197–203 (abstract).

    Article  CAS  PubMed  Google Scholar 

  18. Aiyagiri V, Deibert E, Diringer MN. Hypernatraemia in the neurologic intensive care unit: how high is too high? J Crit Care. 2000;21:163–72.

    Article  Google Scholar 

  19. Andreucci V, Russo D, Cianciaruso B, Andreucci M. Some sodium potassium and water changes in the elderly and their treatment. Nephrol Dial Transplant. 1996;(11 Supp 19):9–17.

    Google Scholar 

  20. Rudolph EH, Pendergraft WF, Lerma EV. Hypernatraemia. Hospital Physician www.turner.white.com/pdf/brm_IM_V14P1.pdf. Retrieved 1 Mar 2015.

Disorders of Potassium

  1. Rastergar A, Soleimani M. Hypokalaemia and hyperkalaemia. Postgrad Med J. 2001;77:759–64.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Stockigt JR. Potassium metabolism. Anaesth Intensive Care. 1977;5(4):317–25 (abstract).

    CAS  PubMed  Google Scholar 

  3. Rose BD, Post TW. Clinical physiology of acid-base and electrolyte disorders. 5th ed. New York: McGraw-Hill; 2001. p. 383–96.

    Google Scholar 

  4. Suki WN. Disposition and regulation of body potassium: an overview. Am J Med Sci. 1976;272(1):31–41 (abstract).

    Article  CAS  PubMed  Google Scholar 

  5. Rose BD, Sterns RH, Post TW. Causes of Hyperkalaemia. In UpToDate. Physician level topic. 2008.

    Google Scholar 

  6. Traeger KA, Wen S-F. Pathophysiology of potassium metabolism. http://mededconnect.com/samplechapters/9781416043911/Sample%20Chapter.pdf. Accessed 2 Mar 2015.

  7. Urwin RJ, Luft FC, Shirley DG. Pathophysiology and management of hypokalaemia: a clinical perspective. Nat Rev Nephrol. 2011;7:75.

    Article  Google Scholar 

  8. Lederer E, Ouseph R, Yasel L. Hypokalaemia e Medicine 2007. http://www.google.com.au/search/hl=en&q=pathophysiology+hypokalaemia&btngG=Google+Search &meta=

  9. Paici B, Gray TM, McBride D, et al. Hyperkalaemia in patients in hospital. Br Med J. 1983;286:1159–92.

    Article  Google Scholar 

  10. Moore ML, Bailey RR. Hyperkalaemia in patients in hospital. N Z Med J. 1989;102:557–8.

    CAS  PubMed  Google Scholar 

  11. Willard MD. Disorders of potassium homeostasis. Vet Clin North Am Small Anim Pract. 1989;19(2):241–6 (abstract).

    Article  CAS  PubMed  Google Scholar 

  12. Pepin J, Shields C. Advances in diagnosis and management of hypokalaemia and hyperkalaemia in emergencies. Emerg Med Pract. 2012;14(2):1–7 (abstract).

    PubMed  Google Scholar 

  13. Sood MM, Sood AR, Richardson R. Emergency management and commonly encountered outpatient scenarios in patients with hyperkalaemia. Mayo Clin Proc. 2007;82(12):1553–61 (abstract).

    Article  PubMed  Google Scholar 

Disorders of Calcium Metabolism

  1. Peacock M. Calcium metabolism in health and disease. Clin J Am Soc Nephrol. 2010;(5 Suppl 1):S23–30.

    Google Scholar 

  2. Frolich A. Prevalence of hypercalcaemia in normal and hospital populations. Dan Med Bull. 1998;45(4):436–9 (abstract).

    CAS  PubMed  Google Scholar 

  3. Sexton TB, Cohen C. Hypercalcaemia and calcium metabolism in the elderly. Contem Geriatric Med. 1988;3:437–53 (abstract).

    Google Scholar 

  4. Koh LK. The diagnosis and management of hypercalcaemia. Ann Acad Med Singapore. 2003;32(1):129–39.

    CAS  PubMed  Google Scholar 

  5. Cooper MS, Gittoes NJL. Diagnosis and management of hypocalcaemia. BMJ. 2008;336(7556):1298–302.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Beach CB. Hypocalcaemia emedicine http://emedicine.midscape.com/activity/767260-overview. Accessed 13 Dec 2008.

Download references

Author information

Authors and Affiliations

  1. Sydney Medical School (Westmead), The University of Sydney, North Rocks, Australia

    Nages Nagaratnam

  2. Norwest Specialist Medical Group, Bella Vista, New South Wales, Australia

    Kujan Nagaratnam

  3. Blacktown-Mt Druitt Hospital, Blacktown, New South Wales, Australia

    Gary Cheuk

Authors
  1. Nages Nagaratnam
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kujan Nagaratnam
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gary Cheuk
    View author publications

    You can also search for this author in PubMed Google Scholar

Appendices

Multiple Choice Questions

  1. 1.

    The following associated with hypercalcaemia are true, EXCEPT:

    1. A.

      Malignancy and hyperparathyroidism are the most common causes of hypercalcaemia.

    2. B.

      In case of hypercalcaemia due to malignancy (to have a tumour),in some the PTHrP is elevated.

    3. C.

      Hypercalcaemia occurs with immobilisation especially high-risk patients are those associated with Paget’s disease.

    4. D.

      Hypercalcaemia caused by vitamin excess is usually due to calcitriol characterised by elevation of calcium, PO4 and serum PTH.

  2. 2.

    In the elderly the following which may contribute to the development of hyponatraemia are true, EXCEPT:

    1. A.

      There is increase in the percentage of body water with ageing.

    2. B.

      There is a decline in the glomerular filtration rate.

    3. C.

      There is increased incidence of renal diseases with advancing years.

    4. D.

      Thirst increases with ageing with loss of water in the urine and inability to concentrate urine.

  3. 3.

    The following are true in relation to hyponatraemia in the elderly, EXCEPT:

    1. A.

      The secretion of aldosterone is altered in the elderly and atrial naturetic peptide is decreased in the elderly fivefold.

    2. B.

      Serum osmolality and sodium concentration are controlled by thirst, antidiuretic hormone and the kidney.

    3. C.

      In SIADH in spite of low osmolality, antidiuretic hormone release is not fully suppressed.

    4. D.

      SIADH is known to occur without an identifiable cause in the elderly.

Answers to MCQs

1 = D; 2 = D; 3 = D

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Nagaratnam, N., Nagaratnam, K., Cheuk, G. (2016). Electrolyte Disturbances and Disorders of Mineral Metabolism in the Elderly. In: Diseases in the Elderly. Springer, Cham. https://doi.org/10.1007/978-3-319-25787-7_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-25787-7_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-25785-3

  • Online ISBN: 978-3-319-25787-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation