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Journal of Nephrology
Published in: Journal of Nephrology 2/2024

26-10-2023 | Hyponatremia | Research Letter

Euvolemic hypotonic hyponatremia in SIAD and thiazide-treated patients: similarities and differences

Authors: Vincenzo Bassi, Valentina Apuzzi, Marta Sodano, Olimpia Fattoruso

Published in: Journal of Nephrology | Issue 2/2024

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Excerpt

Hyponatremia (serum sodium < 135 mmol/L) is found in nearly 15% of hospitalized patients, in whom the syndrome of inappropriate antidiuresis (SIAD) represents the most frequent cause (30–40%). In the late fifties, Schwartz and Bartter identified SIAD in hyponatremic patients suggesting the diagnostic criteria that are utilized in the current algorithms of international guidelines for the differential diagnosis. Unfortunately, bias caused by low diagnostic sensitivity and specificity of clinical assessment of the volemic state can complicate the diagnostic approach. Thus, the European Guideline Committee suggests algorithms that prioritize urine osmolality and sodium over volume status [1]. …
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Literature
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Spasovski G, Vanholder R, Allolio B et al (2014) Hyponatraemia guideline development group. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Nephrol Dial Transplant 29(Suppl 2):1–39CrossRef
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Kim GH, Lee JW, Oh YK et al (2004) Antidiuretic effect of hydrochlorothiazide in lithium-induced nephrogenic diabetes insipidus is associated with upregulation of aquaporin-2, Na-Cl cotransporter, and epithelial sodium channel. J Am Soc Nephrol 15(11):2836–2843CrossRefPubMed
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Ware JS, Wain LV, Channavajjhala SK et al (2017) Phenotypic and pharmacogenetic evaluation of patients with thiazide-induced hyponatremia. J Clin Invest 127:3367–3374CrossRefPubMedPubMedCentral
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Bassi V, Fattoruso O (2020) The role of fractional excretion of uric acid in the differential diagnosis of hypotonic hyponatraemia in patients with diuretic therapy. Cureus 12(4):e7762PubMedPubMedCentral
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Filippone EJ, Ruzieh M, Foy A (2020) Thiazide-associated hyponatremia: clinical manifestations and pathophysiology. Am J Kidney Dis 75(2):256–264CrossRefPubMed
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Metadata
Title
Euvolemic hypotonic hyponatremia in SIAD and thiazide-treated patients: similarities and differences
Authors
Vincenzo Bassi
Valentina Apuzzi
Marta Sodano
Olimpia Fattoruso
Publication date
26-10-2023
Publisher
Springer International Publishing
Published in
Journal of Nephrology / Issue 2/2024
Print ISSN: 1121-8428
Electronic ISSN: 1724-6059
DOI
https://doi.org/10.1007/s40620-023-01784-9

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