Diagnosis and management of hyponatremia in cancer patients.
BACKGROUND
Hyponatremia is among the metabolic disturbances encountered in oncology. Risk factors for hyponatremia include chemotherapy, treatment-induced nausea and vomiting, hydration, pain, narcotic drugs, and physical and emotional stress. A common cause of hyponatremia in patients with cancer is the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), which may result from ectopic production of arginine vasopressin (AVP) by the tumor tissue.


METHODS
The AVP-receptor antagonists, a new class of agents, correct hyponatremia by directly blocking the binding of AVP with its receptors. In clinical trials, conivaptan, lixivaptan, tolvaptan, and satavaptan have increased serum osmolality and normalized the serum [Na(+)] in hyponatremia associated with SIADH, cirrhosis, or congestive heart failure. These drugs may have a potential in cancer-related hyponatremia as well.
Raftopoulos
Harry
H
Columbia University, New York, NY 10032, USA. hr43@columbia.edu
D065092:Antidiuretic Hormone Receptor Antagonists; D001127:Arginine Vasopressin; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D007177:Inappropriate ADH Syndrome; D009369:Neoplasms / Q000150:complications* / Q000503:physiopathology; D012307:Risk Factors
D065092:Antidiuretic Hormone Receptor Antagonists; D001127:Arginine Vasopressin
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