Syndrome of inappropriate secretion of antidiuretic hormone associated with angiotensin-converting enzyme inhibitor therapy in the perioperative period

Journal of the Renin-angiotensin-aldosterone System : JRAAS
Takashin NakayamaSatoru Komatsumoto

Abstract

Angiotensin-converting enzyme (ACE) inhibitors are one of the most commonly used medications for hypertension. Rarely, ACE inhibitors have the potential to cause a syndrome of inappropriate secretion of antidiuretic hormone (SIADH). A 70-year-old woman with > 10 years ACE inhibitor therapy with normonatremia suddenly developed severe SIADH when she took a liquid diet in the uneventful perioperative period, with hemodynamic stability and no surgical complications. She promptly recovered from SIADH subsequent to discontinuing the ACE inhibitor therapy and changing her diet. Therefore, it was assumed that excess antidiuretic hormone secretion due to an ACE inhibitor and free water load from the liquid diet contributed to hyponatremia in our patient. Patients treated with an ACE inhibitor can latently experience inappropriate secretion of antidiuretic hormone, and rapidly develop severe hyponatremia together with additional factors affecting water or salt homeostasis regardless of the length of the administration duration. Clinicians should monitor serum sodium levels in such patients not only just after the initiation of ACE inhibitors but also upon the appearance of those factors.

References

Mar 1, 1992·The American Journal of the Medical Sciences·D Subramanian, J C Ayus
Dec 1, 1987·Postgraduate Medical Journal·J G Collier, D J Webb
May 2, 1987·British Medical Journal·E J Thomas, I D Cooke
Jul 1, 1993·Archives of Family Medicine·H Gonzalez-MartinezD V Espino
Jan 1, 1993·Journal of Internal Medicine·J L CastrillónR Valle
Feb 17, 2000·The Annals of Pharmacotherapy·Z H ShaikhL A Llerena
May 29, 2000·The New England Journal of Medicine·H J Adrogué, N E Madias
Feb 15, 2002·Journal of the American Geriatrics Society·Z H ArinzonZ G Fidelman
Dec 4, 2002·Journal of Clinical Pathology·B O SaeedJ U Weaver
May 18, 2010·Farmacia hospitalaria : órgano oficial de expresión científica de la Sociedad Española de Farmacia Hospitalaria·E Arroyo DomingoL Andreu Giménez
Oct 25, 2011·Indian Journal of Pharmacology·Syed Ahmed ZakiPreeti Shanbag
Jun 12, 2013·Semergen·J M Prieto de PaulaS Franco Hidalgo

Citations

Aug 13, 2020·Curēus·Yiran JiangKaitlin Gordon
Apr 15, 2020·The Journal of Clinical Endocrinology and Metabolism·Henrik FalhammarBuster Mannheimer

Methods Mentioned

BETA
X-ray

Related Concepts

Related Feeds

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.