<p>Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH): Optimal Management</p>

Abstract

Hyponatremia, defined as serum sodium concentration <135 mEq/l, is the most common electrolyte balance disorder in clinical practice. Many causes are listed, but syndrome of inappropriate antidiuretic hormone secretion (SIADH) is certainly the most relevant, mainly in oncological and hospitalized patients. In this review, the pathophysiological and clinical aspects are described in detail. Patients’ extensive medical history and structured physical and biochemical tests are considered the milestones marking the way of the SIADH management as to provide early detection and proper correction. We focused our attention on the poor prognostic role and negative effect on patient’s quality of life of SIADH-induced hyponatremia in both malignant and non-malignant settings, stressing how optimal management of this electrolyte imbalance can result in improved outcomes and lower health costs.

Preoperative hyponatremia predicts complications in older patients undergoing digestive tract surgery: a propensity score matching analysis

“…The most prevailing cause of hyponatremia in older inpatients is SIADH [8]. SIADH is a disorder characterized by inappropriate secretion of antidiuretic hormone (ADH) in the absence of adequate stimuli, leading to impaired water excretion and hypotonic and euvolemic hyponatremia [2,23]. In addition to the frequent causes (e.g., cancers, pulmonary or central nervous system diseases, and drugs), a cause of SIADH worth a special mention is the idiopathic factor, which is considered to be related to aging [9].…”

Fluid management in hospitalized pediatric patients

“…Although there are pharmacological therapies including oral urea or vaptans, which competitively bind the renal vasopressin receptor, these therapies have not been entirely established in children 88,89 . Typically, a fluid restriction goal of 60%–75% of the maintenance rate is sufficient in children, with adults needing a goal of <800 ml/day 90,91 . Achieving this fluid restriction yet providing optimal calories for growth is especially challenging in younger children and infants.…”

“…88,89 Typically, a fluid restriction goal of 60%-75% of the maintenance rate is sufficient in children, with adults needing a goal of <800 ml/day. 90,91 Achieving this fluid restriction yet providing optimal calories for growth is especially challenging in younger children and infants. Often a very high-calorie formula or higher dextrose content is needed in infants with SIADH.…”

Effect of storage duration and analyte concentration on measurement of neutral pH clinical chemistry urine analytes

“…15 SIADH has characteristics of hypotonia, euvolemic hyponatremia with urinary hyperosmolarity occurring from antidiuretic hormone (ADH). 16 Severe hyponatremia was often associated with adverse outcomes as its being recognized that even mild hyponatremia can be associated with patient harm. 17…”