The differential risk of severe hyponatraemia based on the use patterns of hyponatraemia-inducing medications in older adults

Kwanghee Jun; Young-Mi Ah; Jaekyu Shin; Ju-Yeun Lee

doi:10.1093/ageing/afad026

journal article Mar 01, 2023

The differential risk of severe hyponatraemia based on the use patterns of hyponatraemia-inducing medications in older adults

Kwanghee Jun

Young-Mi Ah Jaekyu Shin Ju-Yeun Lee

Age and Ageing Vol. 52 No. 3 · Oxford University Press (OUP)

View at Publisher Save 10.1093/ageing/afad026

Abstract

AbstractBackgroundthe identification and minimization of hyponatraemia-inducing medication (HIM) usage is among the effective strategies for preventing hyponatraemia. However, the differential risk of severe hyponatraemia is unknown.Objectiveto evaluate the differential risk of severe hyponatraemia associated with newly started and concurrently used HIMs in older people.Design and settinga case–control study using national claims databases.Methodswe identified patients aged &gt;65 years with severe hyponatraemia as those hospitalised with a primary diagnosis of hyponatraemia or who had received tolvaptan or 3% NaCl. A 1:20 matched control with the same visit date was constructed. Multivariable logistic regression was performed to assess the association of newly started or concurrently used HIMs comprising 11 medication/classes with severe hyponatraemia after covariate adjustment.Resultsamong 47,766,420 older patients, we identified 9,218 with severe hyponatraemia. After adjusting for covariates, all HIM classes were found to be significantly associated with severe hyponatraemia. Compared with persistently used HIMs, newly started HIMs increased the likelihood of severe hyponatraemia for eight classes of HIMs, with the highest increase being observed for desmopressin (adjusted odds ratio: 3.82, 95% confidence interval: 3.01–4.85). Concurrent use increased the risk of severe hyponatraemia compared to that with individually administered HIMs: thiazide-desmopressin (4.86, 3.90–6.07), medications causing the syndrome of inappropriate anti-diuretic hormone secretion (SIADH)-desmopressin (2.65, 2.25–3.11), medications causing SIADH-thiazides (1.87, 1.75–1.98) and combination among medications causing SIADH (1.36, 1.28–1.45).Conclusionsin older adults, newly started and concurrently used HIMs increased the risk of severe hyponatraemia compared with persistently and singly used HIMs.

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References

Details

Published: Mar 01, 2023
Vol/Issue: 52(3)
License: View

Authors

K

Kwanghee Jun

College of Pharmacy, Seoul National University , Seoul 08826, Republic of Korea

Y

Young-Mi Ah

College of Pharmacy, Yeungnam University , Gyeongsan 38541, Republic of Korea

J

Jaekyu Shin

University of California Department of Clinical Pharmacy, School of Pharmacy, , San Francisco 94143-0622 , USA

J

Ju-Yeun Lee

College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University , Seoul 08826, Republic of Korea

Funding

Korean Government Award: 2020R1A2C110097111

Cite This Article

Kwanghee Jun, Young-Mi Ah, Jaekyu Shin, et al. (2023). The differential risk of severe hyponatraemia based on the use patterns of hyponatraemia-inducing medications in older adults. Age and Ageing, 52(3). https://doi.org/10.1093/ageing/afad026

The differential risk of severe hyponatraemia based on the use patterns of hyponatraemia-inducing medications in older adults

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