Hiponatremia y síndrome de secreción inadecuada de ADH (SIADH) La hiponatremia en la insuficiencia cardíaca: fisiopatología y enfoque farmacológico . Transcript of SIADH HIPONATREMIA. N E F R O L O G Í A CENTRO MÉDICO NACIONAL, 20 DE NOVIEMBRE. ISSSTE ÍNDROME DE S. antidiuretic hormone (SIADH) is the most frequent cause of hyponatraemia in hospital SIADH is the clinical and biochemical manifestation of a wide range of .
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The maintenance of normal plasma osmolality depends on the interaction of some complex mechanisms that regulates the extracellular fluid and sodium levels, involving antidiuretic hormone ADH actions, thirst, and the renin-angiotensin-aldosterone system. The clinical presentation of both syndromes is similar and the differential diagnosis may be difficult.
The determination of the volemic state is essential for the diagnosis, since the patients with the SIADH are characterized for being euvolemic or hypervolemic, while those with CSWS are hypovolemic. Several methods are used to detect the volemic state of those patients, such as the determination of plasma and urinary osmolality, water deprivation test, hypertonic load test and the test of the furosemide that can be discriminatory for the SIADH and CSWS. The treatment of polyuric syndromes depends on their etiology, and includes vasopressin analogs dDAVPdiuretics chlorothiazide, hydrochlorothiazide and amilorideand other drugs such as clorpropramide, hydroclorothiazide, clofibrate, glucocorticoids, carbamazepine and indomethacin.
In contrast, the treatment of CSWS requires volume replacement with supply of sodium and liquids, and the fludrocortisone can be a good therapeutic alternative. The diagnosis and treatment of these syndromes are discussed in view of the literature. Antidiuretic hormone; Hyponatremia; Diabetes insipidus; Syndrome inappropriate secretion of antidiuretic hormone; Cerebral salt wasting; Pituitary surgery. Existem dois tipos de PP: Um gene foi mapeado no cromossomo 4p Tumores do sistema nervoso central como craniofaringioma, disgerminoma, meningioma, glioma, astrocitoma e germinoma da pineal podem causar DI, sendo o craniofaringioma a neoplasia mais comumente envolvida 6,7,12, Os sinais e sintomas na SIADH dependem do grau da hiponatremia e da velocidade com que se instala Pode ser obtida em amostras isoladas ou de urina de 24 horas.
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