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NDT Plus 2009 2(Supplement 3):iii5-iii11; doi:10.1093/ndtplus/sfp153
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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]

SIADH and hyponatraemia: why does it matter?

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

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

Correspondence: Correspondence and offprint requests to: Ewout J. Hoorn; E-mail: ejhoorn{at}gmail.com


  Abstract

The vasopressin-receptor antagonists have received approval for the treatment of hyponatraemia secondary to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). It is therefore necessary that physicians encountering hyponatraemia focus on SIADH. Recent studies show that hyponatraemia is often poorly managed—insufficient diagnostic tests are ordered and patients are undertreated. At the same time, it has become clear that chronic hyponatraemia causes neurological symptoms such as gait disturbances and attention deficits. However, physicians often tolerate chronic hyponatraemia as if it were benign, or as if its treatment would cause significant morbidity. Therefore, physicians must reconsider the diagnostic and therapeutic approaches to hyponatraemia and SIADH.

Key Words: adrenal insufficiency • diagnosis • epidemiology • vasopressin • vasopressin-receptor antagonists

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


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