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Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)

Elise Joyce Barney, DO Reviewed 06/2022
 


BASICS

SIADH is a common cause of hyponatremia in hospitalized patients. 

DESCRIPTION

  • The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is a disorder with impaired water excretion ...

DIAGNOSIS

  • Bartter and Schwartz criteria for SIADH:

    • Decreased osmolality (<275 mosm/kg) with inappropriately concentrated urine (>100 mosm/kg) and euvolemia

  • Signs and symptoms depend upon...

TREATMENT

GENERAL MEASURES

  • Treatment of the underlying cause is essential.

  • Fluid restriction (usually <1,000 mL/day) is the main treatment (2)[B].

  • Avoid isotonic saline because this can worsen the hy...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Careful continuous clinical and laboratory monitoring of hyponatremic state during the acute phase:

    • Hourly urine output

    • Urine Na, urine potassium,...

REFERENCES

1
Decaux  G, Musch  W. Clinical laboratory evaluation of the syndrome of inappropriate secretion of antidiuretic hormone. Clin J Am Soc Nephrol.  2008;3(4):1175–...

SEE ALSO

Hyponatremia 

CODES

ICD10

E22.2 Syndrome of inappropriate secretion of antidiuretic hormone 

SNOMED

55004003 Syndrome of inappropriate vasopressin secretion (disorder) 

CLINICAL PEARLS

  • Treatment of the underlying cause is key. Review all medications for potential culprits.

  • Fluid restriction is the mainstay of treatment in SIADH. Fluid restriction fails to correct hypo...

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