HYPERNATREMIA AND COPEPTIN LEVELS IN THE ELDERLY HOSPITALIZED PATIENT.
Endocr Pract. 2016 Sep 15;
Authors: Liber M, Sonnenblick M, Munter G
OBJECTIVE: Elderly patients have a high prevalence of hypernatremia. The aim of this study was to determine demographic and clinical characteristics of the elderly hypernatremic patient hospitalized in the internal medicine ward, and to enhance understanding of the role of ADH secretion in the pathogenesis of hypernatremia.
METHODS: Case-control study performed in an Internal Medicine ward in a University affiliated hospital. 33 elderly hypernatremic patients (admission sodium>150 meq/l, age>70) compared to 34 normonatremic patients. Demographic, functional (mental status and ADL), clinical data (APACHE II score) and serum Copeptin levels, as a marker of ADH secretion, were collected at admission. Mortality and change in the functional status were followed up to 30 days from discharge.
RESULTS: Patients with hypernatremia presented with significantly lower baseline functional and cognitive states and higher APACHE II score (21.3 ±8.6 vs. 15.4 ±6.7, P<, 0.01). Mortality within 30 days after discharge was higher in the hypernatremic group (58% vs. 32%, P<0.05). Higher Copeptin levels were found in the hypernatremic group compared to the normonatremic group (100.2±60.6 pmol/l vs. 66.5±57.2 pmol/l, P<0.05). High levels of Copeptin were associated with higher in hospital (P<0.05) and 30 days mortality (P<0.01). Sodium levels were found correlated with Copeptin levels; yet, an even stronger correlation was found between Copeptin levels and Apache II score (r= 0.52, p<0.001).
CONCLUSIONS: Hypernatremia in the elderly at admission is associated with a high mortality rate. Copeptin level in the elderly seems to be a good single disease severity marker. ADH is strongly secreted in elderly hypernatremic patients.
PMID: 27631841 [PubMed - as supplied by publisher]