title: Considerations regarding the management of hyponatraemia secondary to SIADH.
abstract: Treatment of hyponatraemia secondary to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) should be guided by the symptomatology of the patient, which can be used as a surrogate for the duration of the hyponatraemia. However, in patients with acute symptomatic hyponatraemia (developing in <48 hours), the need to actively treat hyponatraemia is more imperative due to the potential risks associated with leaving hyponatraemia untreated (including the potential for development of serious neurological manifestations, such as seizures and brain stem herniation). In patients with hyponatraemia care needs to be taken not to exceed the recommended rates of correction, as this increases the risk of osmotic demyelination syndrome. This article will discuss the potential impact of prompt intervention in the treatment of hyponatraemia, particularly secondary to SIADH, and the need to weigh the benefits of treatment against the potential risks associated with overly rapid correction.
authors.affiliation: Department of Clinical Physiopathology, Endocrine Unit, Center for Research, Transfer and High Education on Chronic, Inflammatory, Degenerative and Neoplastic Disorders for Development of Novel Therapies (DENOThe), University of Florence, 50139 Florence, Italy. a.peri@dfc.unifi.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Peri
authors.forename: Christian
authors.initials: C
authors.lastname: Combe
mesh_terms: D000368:Aged; D001552:Benzazepines / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D007177:Inappropriate ADH Syndrome / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D012462:Saline Solution, Hypertonic / Q000009:adverse effects / Q000627:therapeutic use; D013997:Time Factors; D000077602:Tolvaptan; D016896:Treatment Outcome; D014867:Water / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D001552:Benzazepines; D012462:Saline Solution, Hypertonic; D014867:Water; D000077602:Tolvaptan