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2013 ; 6
(Suppl 1
): i1-i20
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Hyponatremia secondary to the syndrome of inappropriate secretion of antidiuretic
hormone (SIADH): therapeutic decision-making in real-life cases
#MMPMID26069838
Laville M
; Burst V
; Peri A
; Verbalis JG
Clin Kidney J
2013[Nov]; 6
(Suppl 1
): i1-i20
PMID26069838
show ga
Despite being the most common electrolyte disturbance encountered in clinical
practice, the diagnosis and treatment of hyponatremia (defined as a serum sodium
concentration <135 mmol/L) remains far from optimal. This is extremely troubling
because not only is hyponatremia associated with increased morbidity, length of
hospital stay and hospital resource use, but it has also been shown to be
associated with increased mortality. The reasons for this poor management may
partly lie in the heterogeneous nature of the disorder; hyponatremia presents
with a variety of possible etiologies, differing symptomology and fluid volume
status, thereby making its diagnosis potentially complex. In addition, a general
lack of awareness of the clinical impact of the disorder, a fear of adverse
outcomes through overcorrection of sodium levels, and a lack of effective
targeted treatments until recent years, may all have contributed to a reticence
to actively treat cases of hyponatremia. There is therefore a clear unmet need to
further educate physicians on the pathophysiology, diagnosis and management of
this important condition. Through the use of a variety of real-world cases of
patients with hyponatremia secondary to the syndrome of inappropriate secretion
of antidiuretic hormone-a condition that accounts for approximately one-third of
all cases of hyponatremia-this supplement aims to provide a comprehensive
overview of the challenges faced in diagnosing and managing hyponatremia. These
cases will also help to illustrate how some of the limitations of traditional
therapies may be overcome with the use of vasopressin receptor antagonists.
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