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NDT Plus 2009 2(Supplement 3):iii12-iii19; doi:10.1093/ndtplus/sfp154
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© The Author 2009. Published by Oxford University Press [on behalf of ERA-EDTA].
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.5/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

This article appears in the following NDT Plus issue: SIADH and Hyponatraemia [View the issue table of contents]

Current and future treatment options in SIADH

Robert Zietse, Nils van der Lubbe and Ewout J. Hoorn

Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands

Correspondence: Correspondence and offprint requests to: Robert Zietse; E-mail: r.zietse{at}erasmusmc.nl


  Abstract

The treatment of hyponatraemia due to SIADH is not always as straightforward as it seems. Although acute treatment with hypertonic saline and chronic treatment with fluid restriction are well established, both approaches have severe limitations. These limitations are not readily overcome by addition of furosemide, demeclocycline, lithium or urea to the therapy. In theory, vasopressin-receptor antagonists would provide a more effective method to treat hyponatraemia, by virtue of their ability to selectively increase solute-free water excretion by the kidneys (aquaresis). In this review we explore the limitations of the current treatment of SIADH and describe emerging therapies for the treatment of SIADH-induced hyponatraemia.

Key Words: hyponatraemia • SIADH • urea • vasopressin • vasopressin-receptor antagonist

Received for publication August 25, 2009. Accepted for publication September 29, 2009.


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NDT Plus, November 1, 2009; 2(suppl_3): iii1 - iii4.
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