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[Current considerations in syndrome of inappropriate secretion of antidiuretic hormone/syndrome of inappropriate antidiuresis].
Endocrinol Nutr 2010; 57 Suppl 2:22-9EN

Abstract

The syndrome of inappropriate secretion of antidiuretic hormone (SIADH)/syndrome of inappropriate antidiuresis is characterized by a hypotonic hyponatremia, with an insufficiently diluted urine given the plasmatic hypoosmolality, in the absence of hypovolemia (with or without a third space), hypotension, renal or heart failure, cirrhosis of the liver, hypothyroidism, adrenal insufficiency, vomiting, or other non-osmotic stimuli of ADH secretion. The response of ADH to the infusion of hypertonic saline divides SIADH into 4 different types. In type D, there is no alteration in ADH secretion. Rather, the defect is the maintained permeability of kidney aquaporin-2 channels to water. Activating mutations of the V2 receptor have been identified. The most frequent cause of SIADH is the use of drugs that induce secretion of the hormone. Old age is per se a risk factor for its development. SIADH is underdiagnosed, and hospitalization often worsens the clinical situation, due to an iatrogenic excess in the use of oral and i.v. liquids, often hypotonic, together with a reduction in salt intake. Treatment is directed towards normalization of natremia when possible, together with the avoidance of both hyponatremic encephalopathy as well as the osmotic demyelinization syndrome. Cases of "appropriate" secretion of ADH with normovolemic hyponatremia and high mortality rates should be treated with the same urgency as SIADH--such is the case of post-surgical hyponatremia.

Authors+Show Affiliations

Servicio de Endocrinología, Metabolismo y Nutrición, Hospital Clínico San Carlos, Madrid, Spain.No affiliation info available

Pub Type(s)

English Abstract
Journal Article
Review

Language

spa

PubMed ID

21130959

Citation

Velasco Cano, M V., and Isabelle Runkle de la Vega. "[Current Considerations in Syndrome of Inappropriate Secretion of Antidiuretic Hormone/syndrome of Inappropriate Antidiuresis]." Endocrinologia Y Nutricion : Organo De La Sociedad Espanola De Endocrinologia Y Nutricion, vol. 57 Suppl 2, 2010, pp. 22-9.
Velasco Cano MV, Runkle de la Vega I. [Current considerations in syndrome of inappropriate secretion of antidiuretic hormone/syndrome of inappropriate antidiuresis]. Endocrinol Nutr. 2010;57 Suppl 2:22-9.
Velasco Cano, M. V., & Runkle de la Vega, I. (2010). [Current considerations in syndrome of inappropriate secretion of antidiuretic hormone/syndrome of inappropriate antidiuresis]. Endocrinologia Y Nutricion : Organo De La Sociedad Espanola De Endocrinologia Y Nutricion, 57 Suppl 2, pp. 22-9. doi:10.1016/S1575-0922(10)70019-X.
Velasco Cano MV, Runkle de la Vega I. [Current Considerations in Syndrome of Inappropriate Secretion of Antidiuretic Hormone/syndrome of Inappropriate Antidiuresis]. Endocrinol Nutr. 2010;57 Suppl 2:22-9. PubMed PMID: 21130959.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Current considerations in syndrome of inappropriate secretion of antidiuretic hormone/syndrome of inappropriate antidiuresis]. AU - Velasco Cano,M V, AU - Runkle de la Vega,Isabelle, PY - 2010/12/7/entrez PY - 2010/12/7/pubmed PY - 2011/3/30/medline SP - 22 EP - 9 JF - Endocrinologia y nutricion : organo de la Sociedad Espanola de Endocrinologia y Nutricion JO - Endocrinol Nutr VL - 57 Suppl 2 N2 - The syndrome of inappropriate secretion of antidiuretic hormone (SIADH)/syndrome of inappropriate antidiuresis is characterized by a hypotonic hyponatremia, with an insufficiently diluted urine given the plasmatic hypoosmolality, in the absence of hypovolemia (with or without a third space), hypotension, renal or heart failure, cirrhosis of the liver, hypothyroidism, adrenal insufficiency, vomiting, or other non-osmotic stimuli of ADH secretion. The response of ADH to the infusion of hypertonic saline divides SIADH into 4 different types. In type D, there is no alteration in ADH secretion. Rather, the defect is the maintained permeability of kidney aquaporin-2 channels to water. Activating mutations of the V2 receptor have been identified. The most frequent cause of SIADH is the use of drugs that induce secretion of the hormone. Old age is per se a risk factor for its development. SIADH is underdiagnosed, and hospitalization often worsens the clinical situation, due to an iatrogenic excess in the use of oral and i.v. liquids, often hypotonic, together with a reduction in salt intake. Treatment is directed towards normalization of natremia when possible, together with the avoidance of both hyponatremic encephalopathy as well as the osmotic demyelinization syndrome. Cases of "appropriate" secretion of ADH with normovolemic hyponatremia and high mortality rates should be treated with the same urgency as SIADH--such is the case of post-surgical hyponatremia. SN - 1579-2021 UR - https://www.unboundmedicine.com/medline/citation/21130959/[Current_considerations_in_syndrome_of_inappropriate_secretion_of_antidiuretic_hormone/syndrome_of_inappropriate_antidiuresis]_ L2 - http://linkinghub.elsevier.com/retrieve/pii/S1575-0922(10)70019-X DB - PRIME DP - Unbound Medicine ER -