Functional Obstructive Uropathy: A Significant Factor in the Hyponatremia of Psychogenic Polydipsia?

Moskowitz, David W.

doi:10.1016/s0022-5347(17)37644-9

Cited by 10 publications

(9 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The coexistence of hyponatremia and urinary retention has been reported in the past in only 1 patient [6] . The patient was a 42-year-old woman with chronic polydipsia and recurrent urinary retention (1,000 and 600 ml), serum sodium levels were 115 mEq/l.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Urinary Retention: A Cause of Hyponatremia?

Galperin¹,

Friedmann²,

Feldman³

et al. 2006

Gerontology

View full text Add to dashboard Cite

Background: Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of hyponatremia in elderly hospitalized patients; however in many patients the etiology remains unclear even after routine investigations. Objective: To report our experience of the association of hyponatremia and urinary retention in elderly hospitalized patients. Patients: Six patients with hyponatremia and urinary retention who were admitted to the geriatric department in our hospital during a four-year period (2001–2004). Results: The mean age of the patients was 85 years. The mean serum sodium level was 120 mEq/l, average volume of retained urine was 933 ml (range 500–1,500 ml). All patients underwent a comprehensive work-up seeking a possible cause for the hyponatremia. The diagnostic work-up was negative. In 5 of the patients the laboratory findings fulfilled the criteria for SIADH. In all patients hyponatremia resolved following urinary catheterization and fluid restriction. All patients made a complete recovery. Conclusions: Potentially, urinary retention by itself may cause hyponatremia. The possible mechanism for this is SIADH, triggered by bladder distention or pain due to bladder distention. Urinary catheterization may be the key to treatment in these cases of hyponatremia.

show abstract

Section: Discussionmentioning

confidence: 99%

“…retention. A Medline search revealed only one case report of hyponatremia associated with urinary retention [6] . We report the clinical findings in our 6 patients and discuss the possible pathogenesis.…”

Section: Introductionmentioning

confidence: 99%

Urinary Retention: A Cause of Hyponatremia?

Galperin¹,

Friedmann²,

Feldman³

et al. 2006

Gerontology

View full text Add to dashboard Cite

show abstract

“…Miscellaneous cases of water intoxication identified in this review included anorexia nervosa, 112 a self-remedy for chronic hiccups, 62 93 123 replacing fluids during acute gastroenteritis 83 109 or respiratory tract infection 145 ; providing a urine sample for drug testing. 10 128 132 167 In the latter case, paruresis (difficulty urinating in public; present in up to 25% of the general population) may lead to emotion stress and antidiuretic hormone release and lower the threshold for water intoxication.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and outcomes of hyponatraemia associated with oral water intake in adults: a systematic review

et al. 2021

View full text Add to dashboard Cite

IntroductionExcessive water intake is rarely associated with life-threatening hyponatraemia. The aim of this study was to determine the clinical characteristics and outcomes of hyponatraemia associated with excess water intake.MethodsThis review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All studies (case reports, observational or interventional studies) reporting excess water intake and hyponatraemia in adults (1946–2019) were included.ResultsA total of 2970 articles were identified and 177 were included (88.7% case reports), consisting of 590 patients. The mean age was 46±16 years (95% CI 44 to 48 years), 47% female, 52% had a chronic psychiatric disorder and 31% had no underlying condition. The median volume of water consumed and serum sodium at presentation was 8 L/day (95% CI 8.9 to 12.2 L/day) and 118 mmol/L (95% CI 116 to 118 mmol/L), respectively. The motivator for increased water consumption was psychogenic polydipsia (55%); iatrogenic (13%); exercise (12%); habitual/dipsogenic polydipsia (7%) and other reasons (13%). The clinical features on presentation were severe in 53% (seizures, coma); moderate in 35% (confusion, vomiting, agitation) and mild in 5% (dizziness, lethargy, cognitive deficit) and not reported in 5% of studies. Treatment was supportive in 41% of studies (fluid restriction, treatment of the underlying cause, emergency care), and isotonic and hypertonic saline was used in 18% and 28% of cases, respectively. Treatment-related complications included osmotic demyelination (3%) and rhabdomyolysis (7%), and death occurred in 13% of cases.ConclusionWater intoxication is associated with significant morbidity and mortality and requires daily intake to substantially exceed population-based recommendations. The limitations of this analysis are the low quality and high risk of bias of the included studies.PROSPERO registration numberA pre-existing protocol in the international prospective register of systematic reviews was updated to incorporate any new amendments and reregistered at http://www.crd.york.ac.uk/PROSPERO (registration no. CRD42019129809).

show abstract

“…In four patients, the sodium level corrected slowly within 2 to 10 days 2,6–8 . In five patients, a rapid autocorrection was described, where sodium normalised in 7 to 15 h 4,5,7,9 . No cases were described in which patients were administered desmopressin, as in our cases.…”

Section: Discussionmentioning

confidence: 56%

“…Although it is not a well‐known cause of hyponatraemia, the coexistence of hyponatraemia and urinary retention has been previously described. We performed a search of the literature and found one case series and seven case reports 2–9 describing a total of 14 cases. There was no difference in sex of the patients (seven men and seven women).…”

Section: Discussionmentioning

confidence: 99%

Hyponatraemia caused by transient syndrome of inappropriate antidiuresis to urinary retention

Bilt

Alsma

2023

Internal Medicine Journal

View full text Add to dashboard Cite

Hyponatraemia is frequently seen in the emergency department, possibly caused by the syndrome of inappropriate antidiuresis (SIAD). We report three cases in which we believe urinary retention with bladder distention caused hyponatraemia. Laboratory findings fulfilled the criteria for SIAD, for which no cause was found. Possibly pain or sympathetic nerve system activation leads to SIAD. Brisk diuresis occurred after placement of an indwelling urinary catheter with overly correction of sodium for which treatment was necessary. Clinicians should be aware that placement of an indwelling urinary catheter may prompt brisk water diuresis and a tendency to overcorrection.

show abstract

Functional Obstructive Uropathy: A Significant Factor in the Hyponatremia of Psychogenic Polydipsia?

Cited by 10 publications

References 15 publications

Urinary Retention: A Cause of Hyponatremia?

Urinary Retention: A Cause of Hyponatremia?

Clinical characteristics and outcomes of hyponatraemia associated with oral water intake in adults: a systematic review

Hyponatraemia caused by transient syndrome of inappropriate antidiuresis to urinary retention

Contact Info

Product

Resources

About