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The Underutilization of Urea in the Treatment of SIADH - An Efficacious but Overlooked Solution.
Cureus
November 2024
Anaesthesia, Dow Health Sciences Karachi, Karachi, PAK.
The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a frequent cause of hyponatremia that presents substantial management challenges in clinical settings. Despite a range of treatment options, including fluid restriction, demeclocycline, and vasopressin antagonists, urea remains underutilized, particularly in North America, despite its well-documented efficacy, safety, and cost-effectiveness. Urea corrects hyponatremia by promoting osmotic diuresis without causing significant fluid shifts, making it an ideal treatment for both acute and chronic SIADH.
View Article and Find Full Text PDFLong-Term Persistence of Inappropriate Antidiuretic Hormone Secretion Following Minor Head Injury.
Eur J Case Rep Intern Med
November 2024
Department of Internal Medicine, Iris Hospitals South (Molière), Brussels, Belgium.
Unlabelled: The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a common cause of euvolemic hyponatremia, resulting from non-osmotic release of antidiuretic hormone (ADH). SIADH is frequently associated with neurological conditions, including traumatic brain injury (TBI). TBI-associated SIADH usually develops within days to weeks and resolves within a few weeks.
View Article and Find Full Text PDFComparative study of the effectiveness of tolvaptan versus urea in patients with hyponatremia caused by SIADH.
Rev Clin Esp (Barc)
December 2024
Unidad de Medicina Oral, Cirugía Oral e Implantología, Facultad de Medicina y Odontología, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
Background And Objectives: Hyponatraemia is common in elderly and hospitalised patients, often caused by the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This study evaluates the efficacy and safety of tolvaptan and urea in patients with hyponatraemia and SIADH.
Materials And Methods: An observational cohort study was conducted on 198 patients with SIADH and hyponatraemia (Na+ <135 mmol/L) at the Complejo Hospitalario Universitario de Pontevedra from January 2015 to May 2022.
Syndrome of Inappropriate Antidiuresis.
J Am Soc Nephrol
December 2024
Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York.
Syndrome of inappropriate antidiuresis (SIAD)-the most frequent cause of hypotonic hyponatremia-is mediated by nonosmotic release of arginine vasopressin, which promotes water retention by activating renal vasopressin type 2 (V2) receptors. There are numerous causes of SIAD, including malignancy, pulmonary and central nervous system diseases, and medications. Rare activating mutations of the V2 receptor can also cause SIAD.
View Article and Find Full Text PDFDelayed Emergence of Isolated Secondary Adrenal Insufficiency: A Case Report.
Cureus
October 2024
Family Medicine, Baptist Health of South Florida, Miami, USA.
Article Synopsis
- Secondary adrenal insufficiency (SAI) is a rare condition caused by a deficiency in the adrenocorticotropic hormone (ACTH) from the pituitary gland, leading to symptoms like chronic low sodium levels (hyponatremia), and can present a diagnostic challenge, particularly when there are no identifiable triggers.
- An 80-year-old woman with a history of multiple health issues was diagnosed with isolated adrenal insufficiency after presenting with weakness and fatigue, leading to complications that required specific treatments including corticosteroids.
- This case highlights the importance of recognizing atypical presentations of adrenal insufficiency, as well as the effectiveness of corticosteroid replacement therapy in resolving symptoms and normalizing sodium levels.
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