Differential diagnosis of hyponatraemia.

Hdl Handle:
http://hdl.handle.net/10147/237851
Title:
Differential diagnosis of hyponatraemia.
Authors:
Thompson, Chris; Berl, Tomas; Tejedor, Alberto; Johannsson, Gudmundur
Affiliation:
Academic Department of Endocrinology, Beaumont Hospital and RCSI Medical School, Beaumont Road, Dublin 9, Ireland. christhompson@beaumont.ie
Citation:
Differential diagnosis of hyponatraemia. 2012, 26 Suppl 1:S7-15 Best Pract. Res. Clin. Endocrinol. Metab.
Journal:
Best practice & research. Clinical endocrinology & metabolism
Issue Date:
Mar-2012
URI:
http://hdl.handle.net/10147/237851
DOI:
10.1016/S1521-690X(12)70003-9
PubMed ID:
22469249
Abstract:
The appropriate management of hyponatraemia is reliant on the accurate identification of the underlying cause of the hyponatraemia. In the light of evidence which has shown that the use of a clinical algorithm appears to improve accuracy in the differential diagnosis of hyponatraemia, the European Hyponatraemia Network considered the use of two algorithms. One was developed from a nephrologist's view of hyponatraemia, while the other reflected the approach of an endocrinologist. Both of these algorithms concurred on the importance of assessing effective blood volume status and the measurement of urine sodium concentration in the diagnostic process. To demonstrate the importance of accurate diagnosis to the correct treatment of hyponatraemia, special consideration was given to hyponatraemia in neurosurgical patients. The differentiation between the syndrome of inappropriate antidiuretic hormone secretion (SIADH), acute adrenocorticotropic hormone (ACTH) deficiency, fluid overload and cerebral salt-wasting syndrome was discussed. In patients with SIADH, fluid restriction has been the mainstay of treatment despite the absence of an evidence base for its use. An approach to using fluid restriction to raise serum tonicity in patients with SIADH and to identify patients who are likely to be recalcitrant to fluid restriction was also suggested.
Item Type:
Article
Language:
en
MeSH:
Algorithms; Blood Volume; Diagnosis, Differential; Endocrine System Diseases; Humans; Hyponatremia; Inappropriate ADH Syndrome; Nervous System Diseases; Osmolar Concentration; Sodium; Urine
ISSN:
1532-1908

Full metadata record

DC FieldValue Language
dc.contributor.authorThompson, Chrisen_GB
dc.contributor.authorBerl, Tomasen_GB
dc.contributor.authorTejedor, Albertoen_GB
dc.contributor.authorJohannsson, Gudmunduren_GB
dc.date.accessioned2012-08-09T07:42:28Z-
dc.date.available2012-08-09T07:42:28Z-
dc.date.issued2012-03-
dc.identifier.citationDifferential diagnosis of hyponatraemia. 2012, 26 Suppl 1:S7-15 Best Pract. Res. Clin. Endocrinol. Metab.en_GB
dc.identifier.issn1532-1908-
dc.identifier.pmid22469249-
dc.identifier.doi10.1016/S1521-690X(12)70003-9-
dc.identifier.urihttp://hdl.handle.net/10147/237851-
dc.description.abstractThe appropriate management of hyponatraemia is reliant on the accurate identification of the underlying cause of the hyponatraemia. In the light of evidence which has shown that the use of a clinical algorithm appears to improve accuracy in the differential diagnosis of hyponatraemia, the European Hyponatraemia Network considered the use of two algorithms. One was developed from a nephrologist's view of hyponatraemia, while the other reflected the approach of an endocrinologist. Both of these algorithms concurred on the importance of assessing effective blood volume status and the measurement of urine sodium concentration in the diagnostic process. To demonstrate the importance of accurate diagnosis to the correct treatment of hyponatraemia, special consideration was given to hyponatraemia in neurosurgical patients. The differentiation between the syndrome of inappropriate antidiuretic hormone secretion (SIADH), acute adrenocorticotropic hormone (ACTH) deficiency, fluid overload and cerebral salt-wasting syndrome was discussed. In patients with SIADH, fluid restriction has been the mainstay of treatment despite the absence of an evidence base for its use. An approach to using fluid restriction to raise serum tonicity in patients with SIADH and to identify patients who are likely to be recalcitrant to fluid restriction was also suggested.en_GB
dc.language.isoenen
dc.rightsArchived with thanks to Best practice & research. Clinical endocrinology & metabolismen_GB
dc.subject.meshAlgorithms-
dc.subject.meshBlood Volume-
dc.subject.meshDiagnosis, Differential-
dc.subject.meshEndocrine System Diseases-
dc.subject.meshHumans-
dc.subject.meshHyponatremia-
dc.subject.meshInappropriate ADH Syndrome-
dc.subject.meshNervous System Diseases-
dc.subject.meshOsmolar Concentration-
dc.subject.meshSodium-
dc.subject.meshUrine-
dc.titleDifferential diagnosis of hyponatraemia.en_GB
dc.typeArticleen
dc.contributor.departmentAcademic Department of Endocrinology, Beaumont Hospital and RCSI Medical School, Beaumont Road, Dublin 9, Ireland. christhompson@beaumont.ieen_GB
dc.identifier.journalBest practice & research. Clinical endocrinology & metabolismen_GB
dc.description.provinceLeinsteren
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