title: The diagnosis and management of inpatient hyponatraemia and SIADH.
abstract: BACKGROUND
  Hyponatraemia is a very common medical condition that is associated with multiple poor clinical outcomes and is often managed suboptimally because of inadequate assessment and investigation. Previously published guidelines for its management are often complex and impractical to follow in a hospital environment, where patients may present to divergent specialists, as well as to generalists.
  
  
  METHODS
  A group of senior, experienced UK clinicians, met to develop a practical algorithm for the assessment and management of hyponatraemia in a hospital setting. The latest evidence was discussed and reviewed in the light of current clinical practicalities to ensure an up-to-date perspective. An algorithm was largely developed following consensus opinion, followed up with subsequent additions and amendments that were agreed by all authors during several rounds of review.
  
  
  RESULTS
  We present a practical algorithm which includes a breakdown of the best methods to evaluate volume status, simple assessments for the diagnosis of the various causes and a straightforward approach to treatment to minimise complexity and maximise patient safety.
  
  
  CONCLUSIONS
  The algorithm we have developed reflects the best available evidence and extensive clinical experience and provides practical, useable guidance to improve patient care.
authors.affiliation: Royal Sussex County Hospital, Brighton, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Grant
authors.affiliation: Department of Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK.
authors.forename: John
authors.initials: J
authors.lastname: Ayuk
authors.affiliation: Diabetes and Endocrinology, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: Pierre-Marc
authors.initials: PM
authors.lastname: Bouloux
authors.affiliation: Diabetes and Endocrinology, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Cohen
authors.affiliation: Diabetes and Endocrinology, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Hampshire, UK.
authors.forename: Iain
authors.initials: I
authors.lastname: Cranston
authors.affiliation: Department of Diabetes and Endocrinology, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds, UK.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Murray
authors.affiliation: Department of Endocrinology and Diabetes, Cardiff University School of Medicine, Cardiff, UK.
authors.forename: Aled
authors.initials: A
authors.lastname: Rees
authors.affiliation: Department of Medical Oncology, Christie Hospital, NHS Trust Manchester, Manchester, UK.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Thatcher
authors.affiliation: Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, UK.
authors.forename: Ashley
authors.initials: A
authors.lastname: Grossman
mesh_terms: D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D065092:Antidiuretic Hormone Receptor Antagonists / Q000627:therapeutic use*; D001552:Benzazepines / Q000627:therapeutic use*; D003707:Demeclocycline / Q000627:therapeutic use*; D005440:Fluid Therapy; D006760:Hospitalization; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis / Q000628:therapy*; D007177:Inappropriate ADH Syndrome / Q000175:diagnosis / Q000628:therapy*; D017410:Practice Guidelines as Topic; D000077602:Tolvaptan; D014883:Water-Electrolyte Imbalance / Q000175:diagnosis / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents; D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines; D000077602:Tolvaptan; D003707:Demeclocycline
keywords: ADH antagonists; Hyponatraemia; SIADH