Gender differences of sodium metabolism and hyponatremia as an adverse drug effect.

Gender-related differences in sodium (Na+) metabolism, Na+ transport through cell membrane, intracellular Na+ concentration, and Na+ urinary excretion review is presented in the article. Literature data on gender-related differences in the occurrence of hyponatremia and related neurology are overviewed. Some of the drugs used in neurology (carbamazepine, oxcarbazepine, thiazides, antidepressants) are pointed out as eventual sources of hyponatremia. This disorder shows a clear-cut preference of the feminine gender. The authors present literature data on gender-related differences in the mechanisms of Na+ transport (Na+/H+ exchange, Na+/K+/2Cl- cotransport, Na+, K+-ATPase). The reasons for such differences are not yet known. Investigative tests with animals of both genders, cellular studies and clinical investigations with human males and females could help to answer question why females are more prone to hyponatremia, to select more efficient measures for prevention of hyponatremia and to differentiate specific peculiarities of treatment for patients of either sex.