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3.12.2 - Syndrome of Inappropriate Anti-diuretic Hormone Secretion

from Section 3.12 - Endocrine Disorders

Published online by Cambridge University Press:  27 July 2023

By
Thomas Leith
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. The syndrome of inappropriate anti-diuretic hormone secretion is the most common cause of hyponatraemia in the hospital setting.

  2. 2. It is characterised by impaired water excretion in the setting of persistent or inappropriate release of anti-diuretic hormone.

  3. 3. There are a number of causes, the most common being respiratory disorders, malignancy, neurological disorders and drugs.

  4. 4. It should be suspected in patients with euvolaemic hyponatraemia who have a low plasma osmolality and a high urine osmolality.

  5. 5. Management involves treating the underlying condition and fluid restriction in the first instance.

Keywords

SIADHhyponatraemiahypertonic saline
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 381 - 383
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Fenske, W, Stork, S, Koschker, AC, et al. Value of fractional uric acid excretion in differential diagnosis of hyponatremic patients on diuretics. J Clin Endocrinol Metab 2008;93:2991–7.CrossRefGoogle ScholarPubMed
Hannon, M, Thompson, CJ. The syndrome of inappropriate antidiuretic hormone: prevalence, causes and consequences. Eur J Endocrinol 2010;162:S5–12.CrossRefGoogle ScholarPubMed
Spasovski, G, Vanholder, R, Allolio, B, et al. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Eur J Endocrinol 2014;170:G1.CrossRefGoogle ScholarPubMed
Sterns, RH, Hix, JK, Silver, SM. Management of hyponatremia in the ICU. Chest 2013;144:672–9.CrossRefGoogle ScholarPubMed
Verbalis, JG, Greenberg, A, Burst, V, et al. Diagnosing and treating the syndrome of inappropriate antidiuretic hormone secretion. Am J Med 2016;129:537.CrossRefGoogle ScholarPubMed

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