title: Management of euvolemic hyponatremia attributed to SIADH in the hospital setting.
abstract: Hyponatremia is the most frequent electrolyte disorder in hospitalized patients. Acute and severe hyponatremia can be a life-threatening condition, but recent evidence indicates that also mild and chronic hyponatremia is associated with neurological and extra-neurological signs, such as gait disturbances, attention deficits, falls and fracture occurrence, and bone loss. The syndrome of inappropriate ADH secretion (SIADH) is the most frequent cause of hyponatremia. Hyponatremia secondary to SIADH may result for instance from ectopic release of ADH in lung cancer, from diseases affecting the central nervous system, from pneumonia or other pneumopathies or as a side-effect of various drugs In SIADH, hyponatremia results from a pure disorder of water handling by the kidney, whereas external sodium balance is usually well regulated. Despite increased total body water, only minor changes of urine output and modest oedema are usually seen. Neurological impairment may range from subclinical to life-threatening, depending on the degree and mostly on the rate of serum sodium reduction. The management of hyponatremia secondary to SIADH is largely dependent on the symptomatology of the patient. This review briefly summarizes the main aspects related to hyponatremia and then discusses the available treatment options for the management of SIADH, including vaptans, which are vasopressin receptor antagonists targeted for the correction of euvolemic hyponatremia, such as that observed in SIADH.
authors: Endocrine Unit, Department of Experimental and Clinical Biomedical Sciences University of Florence, Florence, Italy - alessandro.peri@unifi.it.
authors: A
authors: A
authors: Peri
authors: C
authors: C
authors: Giuliani
mesh_terms: D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines / Q000009:adverse effects / Q000627:therapeutic use; D001810:Blood Volume; D001834:Body Water; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D002986:Clinical Trials as Topic; D003707:Demeclocycline / Q000009:adverse effects / Q000627:therapeutic use; D018500:Diabetes Insipidus, Nephrogenic / Q000139:chemically induced; D019468:Disease Management; D004347:Drug Interactions; D006760:Hospitalization; D006801:Humans; D006854:Hydrocortisone / Q000172:deficiency; D007010:Hyponatremia / Q000139:chemically induced / Q000188:drug therapy / Q000209:etiology*; D007037:Hypothyroidism / Q000150:complications; D007177:Inappropriate ADH Syndrome / Q000150:complications* / Q000188:drug therapy; D007685:Kidney Tubules, Collecting / Q000503:physiopathology; D008094:Lithium / Q000009:adverse effects / Q000627:therapeutic use; D015337:Multicenter Studies as Topic; D009994:Osmolar Concentration; D010257:Paraneoplastic Syndromes / Q000150:complications; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use; D000077602:Tolvaptan
chemical_list: D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines; D012462:Saline Solution, Hypertonic; D000077602:Tolvaptan; D003707:Demeclocycline; D008094:Lithium; D006854:Hydrocortisone