title: The syndrome of inappropriate antidiuresis: pathophysiology, clinical management and new therapeutic options.
abstract: Hyponatremia is a marker of different underlying diseases and it can be a cause of morbidity itself; this implies the importance of a correct approach to the problem. The syndrome of inappropriate antidiuresis (SIAD) is one of the most common causes of hyponatremia: it is a disorder of sodium and water balance characterized by urinary dilution impairment and hypotonic hyponatremia, in the absence of renal disease or any identifiable non-osmotic stimulus able to induce antidiuretic hormone (ADH) release; according to its definition, it is diagnosed through an exclusion algorithm. SIAD is usually observed in hospitalized patients and its prevalence may be as high as 35%. The understanding of the syndrome has notably evolved over the last years, as reflected by the significant change in the name, once the syndrome of inappropriate secretion of ADH (SIADH), today SIAD. This review is up to date and it analyses the newest notions about pathophysiological mechanisms, classification, management and therapy of SIAD, including vaptans.
authors.affiliation: Department of Nephrology, Dialysis and Transplantation, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Italy. pasqualeesposito@hotmail.com
authors.forename: Pasquale
authors.initials: P
authors.lastname: Esposito
authors.forename: Giovanni
authors.initials: G
authors.lastname: Piotti
authors.forename: Stefania
authors.initials: S
authors.lastname: Bianzina
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Malul
authors.forename: Antonio
authors.initials: A
authors.lastname: Dal Canton
mesh_terms: D000818:Animals; D001552:Benzazepines / Q000627:therapeutic use; D019468:Disease Management; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D007177:Inappropriate ADH Syndrome / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D009481:Neurophysins / Q000378:metabolism; D011498:Protein Precursors / Q000378:metabolism; D014667:Vasopressins / Q000378:metabolism / Q000627:therapeutic use; D014882:Water-Electrolyte Balance / Q000502:physiology
chemical_list: C438657:AVP protein, human; D001552:Benzazepines; D009481:Neurophysins; D011498:Protein Precursors; C106389:conivaptan; D014667:Vasopressins