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Cited by 15Body Composition Measurement TechniquesPharmaceutical Practices and Patient OutcomesElectrolyte and hormonal disorders

Association of Drug Application and Hydration Status in Elderly Patients

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Hoen, Laura, Pfeffer, Daniel, Zapf, Rico, Raabe, Andrea, Hildebrand, Janosch, Kraft, Johannes, Kalkhof, Stefan·2021·Nutrients
DOI 10.3390/nu13061929PMC PMC8226953
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Abstract

Due to multifactorial reasons, such as decreased thirst and decreased total body water, elderly patients are vulnerable to dehydration. Mild cognitive impairment (MCI) or dementia increase the risk of dehydration and, in turn, dehydration decreases cognitive performance. The study aims to identify and assess differences in hydration status, taking into account patients' drug treatment and diseases, using bioelectrical impedance vector analysis (BIVA), thereby revealing unfavorable aspects of prognosis. 447 geriatric patients (241 women, 206 men) including information on medication and bioelectrical impedance analysis (BIA) were investigated, which allowed studying the association between 40 drugs and the hydration status. First, patients were divided into disease groups. Renal disease and diuretic treatment were significantly different in both sexes, whereas cardiovascular patients differed exclusively for females. Next, drug enrichment was examined in either hyperhydrated or dehydrated patients. Simvastatin, candesartan, bisoprolol, amlodipine, olmesartan, furosemide, torasemide, allopurinol, mirtazapine, pantoprazole, cholecalciferol, and resveratrol showed enrichment depending on hydration status. This study demonstrated that patients can be differentiated and stratified by BIVA, taking into account medication and disease associated with hydration status. Although patients diagnosed with MCI and therefore treated with resveratrol, BIVA still showed evaluated dehydration. This is unfavorable in terms of prognosis and requires special attention.

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  • Hydration status can affect drug enrichment.

    “Fewer are likely to be familiar with the potential for physical binding of ceftriaxone to calcium salts when each is given intravenously [182] or that hydration status, which is for example commonly impaired in acute medical admissions [183], can affect drug enrichment [184].”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [184]

    The Results (section 3.3; page unavailable) report that prescribed medications were enriched in different hydration groups. The Methods (section 2.4; page unavailable) define enrichment as a difference in prescribing frequency. The paper therefore supports an association, but not the implication that hydration status causes drug enrichment or changes drug concentrations. (LLM, conf=0.84)

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Cited by

Sorted by citations

  • ESPEN guideline on nutritional support for polymorbid medical inpatients

    Wunderle, C., Gomes, F., Schuetz, P., Stumpf, F., Austin, P., Ballesteros-Pomar, M. D., Cederholm, T., Fletcher, J., Laviano, A., Norman, K., et al. (2023) · Clinical Nutrition · doi:10.1016/j.clnu.2023.06.023 · Cited by 105 · see citing works

    “Fewer are likely to be familiar with the potential for physical binding of ceftriaxone to calcium salts when each is given intra-venously [182] or that hydration status, which is for example commonly impaired in acute medical admissions [183], can affect drug enrichment [184].”

Authors
Hoen, L., Pfeffer, D., Zapf, R., Raabe, A., Hildebrand, J., Kraft, J., & Kalkhof, S.
Affiliations
  • Coburg University of Applied Sciences (DE)
  • Klinikum Coburg (DE)
Corresponding author
Kalkhof, Stefan
ORCID
Venue
Nutrients
Publisher
MDPI AG
Published
2021-06-04
Volume
13
Issue
6
Pages
1929
ISSN
2072-6643 (ISSN-L)
DOI
10.3390/nu13061929
PMC
PMC8226953
OpenAlex
W3169505182
Cited by
15
References
5
Citations by year
2026: 1 · 2025: 2 · 2024: 3 · 2023: 9
FWCI
1.89
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrients (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Publikationsdatenbank der Fraunhofer-Gesellschaft (Fraunhofer-Gesellschaft) (submittedVersion, other-oa)
  • Fraunhofer-Publica (Fraunhofer-Gesellschaft) (submittedVersion)
Funders
Bavarian State Ministry of Education and Culture, Science and Art (BMUKK) (VII.2.F1116.CO/28/3)
Topics
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Electrolyte and hormonal disorders
Keywords
dehydration, hydration status, elderly patients, drug-drug interactions, bioelectrical impedance vector analysis, bioelectrical impedance analysis, kidney disease, diuretics, cardiovascular disease, mild cognitive impairment, dementia, resveratrol, sex differences
MeSH terms
Organism Hydration Status, Aged, Aged, 80 and over, Body Composition, Dehydration, Pharmaceutical Preparations, Female, Geriatrics, Humans, Male, Nutritional Status, Nutrition Assessment, Cognitive Dysfunction

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