Cancer patient and SIADH
DOI:
https://doi.org/10.32818/reccmi.a9s1a3Keywords:
SIADH, hyponatremia, urea, oncology, metastasesAbstract
The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a condition characterized by elevated secretion of vasopressin and presents with hyponatremia, low plasma osmolality, inappropriately high urine osmolality, and elevated natriuresis. It’s got a highly varied etiology, and its diagnosis is one of exclusion. Treatment is based on fluid restriction, addressing the underlying cause, hypertonic solutions, tolvaptan, or more recently, oral urea.
This case involves an 87-year-old man with a history of cancer, in whom SIADH was discovered during hospitalization for a confusional syndrome, and treatment was initiated with oral urea.
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Gralla RJ, Ahmad F, Blais JD, Chiodo J 3rd, Zhou W, Glaser LA, et al. Tolvaptan use in cancer patients with hyponatremia due to the syndrome of inappropriate antidiuretic hormone: a post hoc analysis of the SALT-1 and SALT-2 trials. Cancer Med. 2017; 6(4): 723-729. doi: https://doi.org/10.1002/cam4.805 (último acceso sept. 2024). DOI: https://doi.org/10.1002/cam4.805
Wendt R, Fenves AZ, Geisler BP. Use of urea for the syndrome of inappropriate secretion of antidiuretic hormone: a systematic review. JAMA Netw Open. 2023; 6(10): e2340313. doi: https://doi.org/10.1001/jamanetworkopen.2023.40313 (último acceso sept. 2024). DOI: https://doi.org/10.1001/jamanetworkopen.2023.40313
Nervo A, D'Angelo V, Rosso D, Castellana E, Cattel F, Arvat E, et al. Urea in cancer patients with chronic SIAD-induced hyponatremia: old drug, new evidence. Clin Endocrinol (Oxf). 2019; 90(6): 842-848. doi: https://doi.org/10.1111/cen.13966 (último acceso sept. 2024). DOI: https://doi.org/10.1111/cen.13966
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