What Serum Sodium Concentration Is Suggestive for Underhydration in Geriatric Patients?

Abstract

Dehydration is a concern among aging populations and can result in hospitalization and other adverse outcomes. There is a need to establish simple measures that can help in detecting low-intake dehydration (underhydration) in geriatric patients. The predictive performance of sodium, urea, glucose, and potassium to discriminate between patients with and without underhydration was evaluated using receiver-operating characteristic (ROC) curve analysis of data collected during the cross-sectional study of patients admitted to the geriatric ward. A total of 358 participants, for whom osmolarity could be calculated with the Khajuria and Krahn equation, were recruited to the study. Impending underhydration (osmolarity > 295 mmol/L) was diagnosed in 58.4% of cases. Serum sodium, urea, fasting glucose, and potassium (individual components of the equation) were significantly higher in dehydrated participants. The largest ROC area of 0.88 was obtained for sodium, and the value 140 mMol/L was found as the best cut-off value, with the highest sensitivity (0.80; 95% CI: 0.74–0.86) and specificity (0.83; 95% CI: 0.75–0.88) for prediction of underhydration. The ROC areas of urea, glucose, and potassium were significantly lower. Serum sodium equal to 140 mmol/L or higher appeared to be suggestive of impending underhydration in geriatric patients. This could be considered as the first-step screening procedure for detecting underhydration in older adults in general practice, especially when limited resources restrict the possibility of more in-depth biochemical assessments.

Are older adults with excessive sodium intake at increased risk of hypohydration?

“…Another interesting aspect of the results of our study is the ability of serum sodium concentration to act as a marker of hypohydration in older adults, as reported by Wojszel, 41 who found that a serum sodium equal to 140 mmol L –1 or higher appeared to be suggestive of impending underhydration in geriatric patients.…”

“…Although the sensitivity analysis has shown that, when excluding participants with self-reported renal disease, the results were consistent with the primary analyses, it is worth noting that other causes of excess sodium in the urine, such as mineralocorticoid deficiency, syndrome of inappropriate antidiuretic hormone secretion, hypothyroidism or hypopituitarism, were not considered in the present study. 40 Another interesting aspect of the results of our study is the ability of serum sodium concentration to act as a marker of hypohydration in older adults, as reported by Wojszel, 41 who found that a serum sodium equal to 140 mmol L -1 or higher appeared to be suggestive of impending underhydration in geriatric patients.…”

Distinguishing Low and High Water Consumers—A Paradigm of Disease Risk

“…A wide range of ROE (e.g., laboratory reference range, 283-1215 mOsm•24 h −1 for women) is possible in adults, as illustrated in Table 3. Because concentrated urine is a primary etiological factor in kidney stone formation and urinary tract infections [13][14][15][16]28,99,100], it is worthy of future studies that identify ways to simply and effectively reduce ROE.…”

“…Similarly, increasing TWI is important for elderly adults who live in geriatric facilities, because dehydration is associated with significant adverse outcomes in older people despite being largely preventable and treatable [121]. For example, two recent European studies published in Nutrients reported that dehydration (P OSM > 295 mOsm•kg −1 ) was observed in 58.4% of 358 individuals (86% > 75 y) [122] and that a S Na+ value ≥ 140 mMol•L −1 could be used as a first-step screening procedure for detecting underhydration in geriatric patients [99]. Similar to LOW, older adults can be encouraged to increase TWI by building upon existing habitual drinking patterns [121].…”

Mineral composition, crystallinity and dielectric evaluation of Bamboo Salt, Himalaya Salt, and Ba’kelalan salt content

“…The mineral composition of salt differs depending on its origin, such as Bamboo salt, Himalaya salt, and Ba'kelalan salt. The excessive consumption of salt within a day can lead to hypernatremia [ 4 ], a condition characterized by a serum sodium concentration exceeding 145 mEq/L [ 5 ]. This can result in frequent vomiting and diarrhea, as the body aims to eliminate the excess salt.…”