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Vol. 159. Issue 3.
Pages 139-146 (August 2022)
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Vol. 159. Issue 3.
Pages 139-146 (August 2022)
Review
Syndrome of inappropriate antidiuretic hormone secretion
Síndrome de secreción inadecuada de hormona antidiurética
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Esteban Pocha,b,c,
Corresponding author
epoch@clinic.cat

Corresponding author.
, Alicia Molinaa, Gastón Piñeiroa
a Servicio de Nefrología y Trasplante Renal, Hospital Clínic, Barcelona, Spain
b IDIBAPS
c Departamento de Medicina, Universidad de Barcelona, Barcelona, Spain
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Abstract

Hyponatremia is the most frequent electrolytic disorder in hospitalized patients, and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), the most frequent cause of hiponatremia with clinically normal extracellular volume. It consists of a disorder of the regulation of body water that obeys to different causes, mainly cancer, pulmonary illnesses, disorders of the central nervous system and diverse drugs. As in any hiponatremia it a physiological knowledge of the regulation of body water and sodium is essential as well as the applicatin of precise diagnostic criteria in order to manage the problem with an effective treatment. The available data until the moment show that the clinical diagnosis of SIADH made by professionals is mainly not supported on the established criteria drawn by experts and this lack of accuracy probably hits in the therapeutic result. The basis of the treatment of the SIADH is to correct its cause, water restriction, solutes (sodium chloride) and the use of vaptans in case of failure of the previous measures.

Keywords:
Hyponatremia
Sodium
Antidiuretic hormone
Vaptans
Vasopressin
Resumen

La hiponatremia es el trastorno electrolítico más frecuente en pacientes hospitalizados, y el síndrome de secreción inadecuada de hormona antidiurética (SIADH), la causa más frecuente de hiponatremia con volumen extracelular clínicamente normal. Se trata de un trastorno de la regulación del agua corporal que obedece a diferentes causas, entre las que destacan las neoplasias, las enfermedades pulmonares, los trastornos del sistema nervioso central y diversos fármacos. Como en cualquier hiponatremia es importante un conocimiento fisiológico de la regulación del agua y del sodio corporal y aplicar unos criterios diagnósticos precisos de cara a poder realizar un tratamiento eficaz. Los datos disponibles hasta el momento demuestran que el diagnóstico clínico de SIADH realizado por profesionales no se sustenta sobre los criterios establecidos por expertos y esta carencia probablemente impacta en los resultados terapéuticos. La base del tratamiento del SIADH es corregir su causa, la restricción hídrica con el aporte de solutos (cloruro sódico) y el uso de vaptanes en caso de falta de respuesta a las medidas anteriores.

Palabras clave:
Hiponatremia
Sodio
Hormona antidiurética
Vaptanes
Vasopresina

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