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Clinical Review
Impact of Mild Chronic Hyponatremia on Falls, Fractures, Osteoporosis, and Death
Am J Orthop. 2013 November;42(11):522-527
Author and Disclosure Information
Christian J. Zaino, MD, Aditya V. Maheshwari, MD, and David S. Goldfarb, MD
There is emerging evidence that mild chronic hyponatremia (MCH), highly prevalent in the elderly and once considered asymptomatic, is a major independent risk factor for falls, fall- related fractures (independent of osteoporosis, age, and sex), impaired attention and gait, reductions in bone mineral density (BMD), and
even death.
Although research on MCH and bone health is emerging and ongoing, it has not been recognized in orthopedics. Orthopedic surgeons must be educated regarding the impact of hyponatremia on bone, as osteoporotic fractures have enormous socioeconomic consequences, and the problem will worsen. Orthopedic surgeons should also be included in research, in education, and in the establishment of diagnostic and treatment protocols.
In this article, we review the current concepts of MCH and its impacts on the skeletal system.