Vnitr Lek 2016, 62(2):152-156

Severe osteoporosis - the story of chronic medication-related hyponatremia

Pavel Polák^1,2,3,*, Petr Husa¹, Hana Matějovská Kubešová²

¹ Klinika infekčních chorob LF MU a FN Brno

² Klinika interní, geriatrická, ošetřovatelství a praktického lékařství LF MU a FN Brno

³ Oddělení klinické hematologie FN Brno

The authors present a case-report of a 73years old woman treated for arterial hypertension within past 15 years with diuretics (thiazides, amiloride and indapamide) and concomitantly with antidepressive trazodone. The patient developed severe osteoporosis after 6 years of such a treatment with multiple fractures even after minor trauma; during whole this period severe hyponatremia without adequate supplementation was documented. Most probably, there exists tight relationship of osteoporosis and hyponatremia in this patient - the authors discuss possible pathophysiological mechanisms at the level of renal tubules, osteoblasts and osteoclasts, hypopituitary-skeletal axis, syndrome of inadequate adiuretin secretion (SIADH) and possible influence of acid-base balance disturbances.

Keywords: alkalosis; antidepressive drugs; diuretics; hyponatremia; osteoporosis

Received: July 29, 2015; Accepted: October 30, 2015; Published: February 1, 2016  Show citation