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Unbound Medicine.
(Diabetes Insipidus and SIADH)
265 results
  • Aquaporins and diseases pathogenesis: From trivial to undeniable involvements, a disease-based point of view. [Review]
    J Cell Physiol. 2021 Feb 08 [Online ahead of print]Ala M, Mohammad Jafari R, … Dehpour AR
  • Aquaporins (AQPs), as transmembrane proteins, were primarily identified as water channels with the ability of regulating the transmission of water, glycerol, urea, and other small-sized molecules. The classic view of AQPs involvement in therapeutic plan restricted them and their regulators into managing only a narrow spectrum of the diseases such as diabetes insipidus and the syndrome of inapprop…
  • Cerebral salt-wasting syndrome in a patient with status epilepticus: a rare association. [Case Reports]
    BMJ Case Rep. 2021 Jan 18; 14(1)Tale S, Kolli M, … Budumuri GVK
  • Hyponatraemia is one of the most common and serious electrolyte abnormalities in patients with neurological diseases. Assessing the intravascular fluid status, urine sodium, urine and serum osmolality helps to narrow down the differential diagnosis. Differentiation between cerebral salt-wasting syndrome (CSWS), diabetes insipidus and syndrome of inappropriate antidiuretic hormone (SIADH) secretio…
  • Hyponatraemia and hypernatraemia: Disorders of Water Balance in Neurosurgery. [Review]
    Neurosurg Rev. 2021 Jan 03 [Online ahead of print]Castle-Kirszbaum M, Kyi M, … Parkin WG
  • Disorders of tonicity, hyponatraemia and hypernatraemia, are common in neurosurgical patients. Tonicity is sensed by the circumventricular organs while the volume state is sensed by the kidney and peripheral baroreceptors; these two signals are integrated in the hypothalamus. Volume is maintained through the renin-angiotensin-aldosterone axis, while tonicity is defended by arginine vasopressin (a…
  • Anticancer Medications and Sodium Dysmetabolism. [Review]
    Eur Endocrinol. 2020 Oct; 16(2):122-130.Krishnamurthy A, Bhattacharya S, … Dutta D
  • Therapeutic advances have revolutionised cancer treatment over the last two decades, but despite improved survival and outcomes, adverse effects to anticancer therapy such as dyselectrolytaemias do occur and need to be managed appropriately. This review explores essential aspects of sodium homeostasis in cancer with a focus on alterations arising from anticancer medications. Sodium and water bala…
  • Clinical characteristics and outcomes in elderly patients undergoing transsphenoidal surgery for nonfunctioning pituitary adenoma. [Journal Article]
    Neurosurg Focus. 2020 10; 49(4):E19.Pereira MP, Oh T, … Aghi MK
  • CONCLUSIONS: The authors' analysis revealed that TSS for NFPA in elderly patients is safe with low complication rates. In this cohort, more elderly patients experienced postoperative hyponatremia, while more nonelderly patients experienced postoperative DI. These findings, combined with the observation of higher DI in patients with more comorbidities and elderly patients experiencing later peaks and troughs in serum sodium, suggest age-related differences in sodium regulation after NFPA resection. The authors hope that their results will help guide discussions with elderly patients regarding risks and outcomes of TSS.
  • Use of Copeptin Levels to Predict the Resolution of Transient Postoperative SIADH. [Case Reports]
    Horm Res Paediatr. 2020; 93(4):258-262.Jones B, Corredor M, … Creo A
  • CONCLUSIONS: Copeptin levels in this infant are consistent with levels described in adults and older children. Obtaining copeptin levels may improve providers' ability to quickly diagnose and manage SIADH amongst other heterogeneous causes of hyponatremia. Lastly, trending copeptin levels improved providers' ability to monitor SIADH progression, and may allow preemptive fluid titration for children with bi- or tri-phasic shifts in osmoregulation after neurological procedures.
  • StatPearls: Neurohypophysis [BOOK]
    StatPearls. StatPearls Publishing: Treasure Island (FL) Santos Fontanez Santos E. SE University of Puerto Rico-SOM De Jesus Orlando O University of Puerto Rico, Medical Sciences Campus, Neurosurgery Section BOOK
  • The neurohypophysis is a structure that is located at the base of the brain. It is a part of the pituitary gland. Its embryological origin is from the neuroectodermal layer called the infundibulum. The neurohypophysis is divided into two regions; the pars nervosa and the infundibular stalk. Sometimes the pars intermedia and the median eminence are included. It secretes oxytocin and vasopressin; v…
  • Recurrent Severe Hyponatremia in a Patient with Sjögren's Syndrome. [Case Reports]
    Electrolyte Blood Press. 2020 Jun; 18(1):19-22.Kim HD, Lee J, … Park CW
  • Sjögren's syndrome (SS) is an autoimmune disease that presents with exocrine gland dysfunction. Renal involvement is common in SS and often results in tubulointerstitial nephritis, renal tubular acidosis, and Fanconi's syndrome. Electrolyte imbalances are commonly the first symptom of renal involvement of SS. The most common feature of dysnatremia in SS is hypernatremia with diabetes insipidus. H…
  • Management of Water and Sodium Disturbances after Transsphenoidal Resection of Pituitary Tumors. [Review]
    Neurol India. 2020 May-Jun; 68(Supplement):S101-S105.Nadel J, Couldwell WT
  • Patients with pituitary masses who undergo transsphenoidal resection are at risk for a number of medical complications postoperatively. Among these are disturbances in fluid and sodium homeostasis, including diabetes insipidus (DI) and syndrome of inappropriate secretion of antidiuretic hormone (SIADH). It is believed that these pathologic states are a result of damage to the hypothalamic-pituita…
  • ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of diabetes insipidus and hyponatraemia. [Journal Article]
    Eur J Endocrinol. 2020 Jul; 183(1):G9-G15.Christ-Crain M, Hoorn EJ, … Wass JAH
  • COVID-19 has changed the nature of medical consultations, emphasizing virtual patient counseling, with relevance for patients with diabetes insipidus (DI) or hyponatraemia. The main complication of desmopressin treatment in DI is dilutional hyponatraemia. Since plasma sodium monitoring is not always possible in times of COVID-19, we recommend to delay the desmopressin dose once a week until aquar…
  • Diagnosis and Management of Disorders of Body Tonicity-Hyponatremia and Hypernatremia: Core Curriculum 2020. [Review]
    Am J Kidney Dis. 2020 02; 75(2):272-286.Seay NW, Lehrich RW, Greenberg A
  • Overall body fluid concentration is regulated within a narrow range by the concerted action of the hypothalamic-pituitary axis to influence water intake through thirst and water excretion via the effect of vasopressin, or antidiuretic hormone, on renal collecting duct water permeability. Sodium is the principal extracellular cation; abnormalities in overall effective body fluid concentration, or …
  • Sodium Perturbations After Pituitary Surgery. [Review]
    Neurosurg Clin N Am. 2019 Oct; 30(4):515-524.Yuen KCJ, Ajmal A, … Little AS
  • Sodium perturbations are a common complication after pituitary surgery, with hyponatremia being the most frequent. Postoperative assessments should be tailored to the early and late periods, and monitoring sodium perturbations is recommended. Cerebral salt wasting is rare after pituitary surgery, and diagnosis and management can be challenging. Providing patient counseling and close postoperative…
  • Clinical Approach to Sodium Homeostasis Disorders in Children with Pituitary-Suprasellar Tumors. [Review]
    Neuroendocrinology. 2020; 110(3-4):161-171.Tuli G, Matarazzo P, de Sanctis L
  • Children with pituitary-suprasellar tumors are at high risk of developing sodium metabolism disorders since the tumoral mass itself or surgical and medical treatment can damage AVP release circuits. Additional risk factors are represented by the use of hypotonic fluids, the young age, total parenteral nutrition, and obstructive hydrocephalus secondary to tumor pathology. The most frequent hyponat…
  • [Nephrogenic syndrome of inappropriate antidiuresis]. [Review]
    Pan Afr Med J. 2019; 32:210.Nawal B, Izzedine H, … Bentata Y
  • Disorders of water balance are a disease commonly encountered in our clinical practice. Analysis of vasopressin receptor type II (V2R) is essential to understand the physiology of water balance and it is used as a biological prototype of G protein-coupled receptors (GPCRs). Nephrogenic syndrome of inappropriate antidiuresis (NSIAD) is a syndrome of inappropriate antidiuretic hormone secretion (SI…
    Endocr Pract. 2019 Sep; 25(9):943-950.Eisenberg Y, Charles S, … Agrawal N
  • CONCLUSIONS: Water and sodium dysregulation are common following transsphenoidal surgery, but their management is not well-standardized in clinical practice. We created a questionnaire to define and compare practice patterns. Most respondents practice in academic settings in multidisciplinary teams. The length of clinical experience did not significantly impact practice habits. Practice location influenced length of stay postoperatively and fluid restriction in SIADH. Abbreviations: AVP = arginine vasopressin; DI = diabetes insipidus; LOS = length of stay; SIADH = syndrome of inappropriate antidiuretic hormone.
  • Copeptin and its role in the diagnosis of diabetes insipidus and the syndrome of inappropriate antidiuresis. [Review]
    Clin Endocrinol (Oxf). 2019 07; 91(1):22-32.Refardt J, Winzeler B, Christ-Crain M
  • Copeptin is secreted in an equimolar amount to arginine vasopressin (AVP) but can easily be measured in plasma or serum with a sandwich immunoassay. The main stimuli for copeptin are similar to AVP, that is an increase in osmolality and a decrease in arterial blood volume and pressure. A high correlation between copeptin and AVP has been shown. Accordingly, copeptin mirrors the amount of AVP in t…
  • A rare cause of postpartum acute hyponatremia. [Journal Article]
    Endocrinol Diabetes Metab Case Rep. 2019 Mar 15; 2019Rahmani Tzvi-Ran I, Olchowski J, … Barski L
  • A previously healthy 24-year-old female underwent an emergent caesarean section without a major bleeding described. During the first post-operative days (POD) she complained of fatigue, headache and a failure to lactate with no specific and conclusive findings on head CT. On the following days, fever rose with a suspicion of an obstetric surgery-related infection, again with no evidence to suppor…
  • Vasopressin-aquaporin-2 pathway: recent advances in understanding water balance disorders. [Review]
    F1000Res. 2019; 8Ranieri M, Di Mise A, … Valenti G
  • The alteration of water balance and related disorders has emerged as being strictly linked to the state of activation of the vasopressin-aquaporin-2 (vasopressin-AQP2) pathway. The lack of responsiveness of the kidney to the vasopressin action impairs its ability to concentrate the urine, resulting in polyuria, polydipsia, and risk of severe dehydration for patients. Conversely, non-osmotic relea…
  • Diabetes Insipidus and Syndrome of Inappropriate Antidiuretic Hormone in Critically Ill Patients. [Review]
    Crit Care Clin. 2019 Apr; 35(2):187-200.Harrois A, Anstey JR
  • Diabetes insipidus and the syndrome of inappropriate antidiuretic hormone secretion lie at opposite ends of the spectrum of disordered renal handling of water. Whereas renal retention of water insidiously causes hypotonic hyponatremia in syndrome of inappropriate antidiuretic hormone secretion, diabetes insipidus may lead to free water loss, hypernatremia, and volume depletion. Hypernatremia and …
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