Clinical laboratory evaluation of the syndrome of inappropriate secretion of antidiuretic hormone

Clinical Journal of the American Society of Nephrology : CJASN
Guy Decaux, Wim Musch

Abstract

Hyponatremia secondary to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is a frequent cause of hypotonicity. Although the differential diagnosis with other causes of hypotonicity such as salt depletion is sometimes challenging, some simple and readily available biologic parameters can be helpful in the diagnosis of SIADH. In SIADH, urea is typically low; this is less specific for elderly patients, for whom lower clearance of urea accounts for higher values. Low levels of uric acid are more often seen in SIADH (70%) compared with salt-depleted patients (40%). Typically, patients with SIADH will show a lower anion gap with nearly normal total CO2 and serum potassium, this despite dilution. In patients with hyponatremia secondary to hypocorticism, total CO2 is usually lower than in nonendocrine SIADH despite low urea and uric acid levels. Urine biology can also be helpful in diagnosis of SIADH because patients with SIADH have high urine sodium (Na; >30 mEq/L), and most of them will have a high fractional excretion of Na (>0.5% in 70% of cases), reflecting salt intake. Conversely, low urine Na in patients with SIADH and poor alimentation is not rare. Finally, measurement of urine osmolality is useful for t...Continue Reading

References

Nov 1, 1975·Kidney International·S GarellaS I Kahn
Jan 1, 1977·Medicine·M Emmett, R G Narins
Sep 6, 1979·The New England Journal of Medicine·L H Beck
Jul 1, 1989·The Journal of Endocrinology·J G VerbalisR R Vollmer
Feb 1, 1985·Kidney International·P A Gabow
Nov 1, 1987·The American Journal of Medicine·H M ChungR J Anderson
Feb 1, 1985·Annals of Internal Medicine·R J AndersonR W Schrier
Oct 1, 1974·Archives of Internal Medicine·M F MichelisB B Davis
May 1, 1967·The American Journal of Medicine·F C Bartter, W B Schwartz
Oct 1, 1970·The American Journal of Medicine·K D Nolph, R W Schrier
Jan 1, 1982·Analytical Chemistry·D IssacharC C Sweeley
Nov 1, 1980·Annals of Internal Medicine·G DecauxJ Mockel
Apr 1, 1993·Annals of Internal Medicine·P M PalevskyW F Diven
Jun 19, 1998·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·S M ThalerT Berl
Feb 20, 1999·QJM : Monthly Journal of the Association of Physicians·W Musch, G Decaux
May 4, 1999·The American Journal of Medicine·T A HillierE J Barrett
Oct 3, 1999·Journal of the American Society of Nephrology : JASN·T MuraseJ G Verbalis
Sep 29, 2000·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·G DecauxW Musch
Sep 27, 2001·Endocrinology and Metabolism Clinics of North America·G L Robertson
Oct 5, 2001·International Urology and Nephrology·W Musch, G Decaux
Oct 22, 2002·American Journal of Physiology. Regulatory, Integrative and Comparative Physiology·Takashi MuraseJoseph G Verbalis
Nov 7, 2003·The Journal of Clinical Endocrinology and Metabolism·G DecauxA Soupart
Jan 31, 2004·Nephron. Physiology·Wim MuschGuy Decaux
May 6, 2005·The New England Journal of Medicine·Brian J FeldmanStephen E Gitelman
Jun 30, 2005·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Marie-Marcelle Trinh-Trang-TanLise Bankir
May 5, 2006·Kidney International·A Greenberg, J G Verbalis
Jul 18, 2006·The American Journal of Medicine·Joseph G Verbalis
Jan 19, 2007·Journal of the American Society of Nephrology : JASN·Guy DecauxCatheline Vilain

❮ Previous
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Citations

Dec 3, 2008·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Hiroya HasegawaMakoto Uchiyama
Feb 24, 2012·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Michael L Moritz
Jan 13, 2010·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Juan Carlos Q VelezJohn M Arthur
Nov 3, 2009·NDT Plus·Robert ZietseEwout J Hoorn
Jun 17, 2011·Nephron. Clinical Practice·Pasquale EspositoAntonio Dal Canton
Mar 2, 2012·American Journal of Nephrology·Julien CoussementMichael Piagnerelli
Jun 1, 2012·Annals of Intensive Care·Charalampos PierrakosSerge Brimioulle
Oct 16, 2010·Critical Care : the Official Journal of the Critical Care Forum·Guy DecauxAlain Soupart
Jan 19, 2011·Journal of Perinatal Medicine·Juan José Hidalgo-MoraAlfredo Perales Marín
Feb 10, 2009·Clinical Journal of the American Society of Nephrology : CJASN·Solomon BitewJohn K Maesaka
Jul 16, 2010·Journal of Endocrinological Investigation·A ManciniA Pontecorvi
Dec 18, 2013·BMC Infectious Diseases·Philipp SchuetzUNKNOWN ProHOSP Study Group
Oct 12, 2010·Journal of Endocrinological Investigation·A PeriP Menè
Aug 8, 2014·Current Treatment Options in Neurology·Michael L Moritz, Juan C Ayus
Nov 3, 2010·Journal of the American Animal Hospital Association·Kristin Cameron, Alexander Gallagher
Oct 23, 2010·Annals of Medicine·George LiamisMoses Elisaf
Feb 18, 2016·Journal of Cancer Research and Therapeutics·Erman AtasGokhan Kalkan
Aug 14, 2012·La Revue de médecine interne·T Frouget
Feb 10, 2012·Revista clínica española·D Abad-PérezI García-Polo
Jul 19, 2011·Archives of Gerontology and Geriatrics·Chung-Kang TsengWen-Yuan Lin
Sep 21, 2010·Fertility and Sterility·Helen BiliBasil C Tarlatzis
Dec 27, 2015·European Journal of Internal Medicine·T D FilippatosM S Elisaf
Oct 5, 2010·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Garabed Eknoyan
Jan 29, 2011·Acta Clinica Belgica·G DecauxA Soupart
Apr 5, 2012·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Jun MiyashitaToru Kamiya
May 28, 2014·Acta Paediatrica·Jakub Zieg
Jun 4, 2014·Journal of Clinical Laboratory Analysis·Ahmet Cumhur DulgerHayrettin Akdeniz
Aug 25, 2009·The American Journal of Medicine·Sushrut S WaikarGary C Curhan
Nov 26, 2016·Acta Clinica Belgica·Fabrice Gankam Kengne
Feb 23, 2017·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Daniel C Andreoli, William L Whittier
Apr 19, 2017·American Journal of Nephrology·Biff F Palmer, Deborah J Clegg
Jan 30, 2010·Nature Reviews. Nephrology·Stefan ReuterEckhart Büssemaker
Nov 11, 2015·Annals of Intensive Care·Cédric RafatDidier Dreyfuss
Nov 21, 2012·Nature Reviews. Nephrology·Robert W SchrierDmitry Shchekochikhin
Dec 4, 2010·Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs·Matteo AttisaniMauro Rinaldi
Oct 19, 2012·The Journal of Clinical Endocrinology and Metabolism·Anne-Sophie SejlingPia Eiken
Feb 6, 2017·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Sridhar Nagepalli Venkatarami ReddyKarthik Rao
Oct 30, 2009·Clinical Chemistry·Joost van der HoekWouter W de Herder
Oct 9, 2019·American Journal of Clinical Oncology·Shruti GuptaSushrut S Waikar
Sep 16, 2017·Terapevticheskiĭ arkhiv·D Yu ShchekochikhinE M Shilov
Jan 24, 2015·The American Journal of Case Reports·Sherif EltawansyMark Babyatsky
Dec 7, 2016·Journal of the American Society of Nephrology : JASN·Olivier DevuystFrank S Czerwiec
Nov 1, 2017·Frontiers in Pediatrics·Jakub Zieg
Jan 27, 2018·American Journal of Hypertension·Biff F Palmer, Deborah J Clegg

❮ Previous
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