ECE2019 ePoster Presentations Pituitary and Neuroendocrinology (37 abstracts)
Etiology of syndrome of inappropriate antidiuretic in patients on parenteral nutrition: prospective multicenter study
Ana Ortolá Buigues 1 , Emilia Gómez Hoyos 1 , María Dolores Del Olmo García 2 , Ana Herrero Ruiz 3 , Julia Álvarez Hernández 4 , Cristina Tejera Pérez 5 , Sandra Herranz Antolín 6 , Irene Bretón Lesmes 7 , Miguel Angel Martínez Olmos 8 & Daniel De Luis Román 1
1Hospital Clínico Universitario de Valladolid, Valladolid, Spain; 2Hospital Universitario Severo Ochoa, Leganés, Spain; 3Hospital Universitario de Salamanca, Salamanca, Spain; 4Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain; 5Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain; 6Hospital General Universitario de Guadalajara, Guadalajara, Spain; 7Hospital General Universitario Gregorio Marañón, Madrid, Spain; 8Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain.
Introduction: Syndrome of Inappropriate Antidiuretic (SIAD) is the most frequent cause of hyponatremia in parenteral nutrition (PN) patients. Moreover, SIAD may be caused by multiple etiologies (drugs; pulmonary, neurological or abdominal disorders; malignant disease; idiopathic…). Our objective was to evaluate the main etiologies of SIAD in patients receiving PN.
Methods: Prospective, non-interventional, multicenter study in 19 Spanish hospitals. Forty- seven patients with SIAD-induced hyponatremia while receiving PN over a 9-month period were recruited. Hyponatraemia was defined as a Serum Na level (SNa) <135 mmol/l. Patient data collected included sex, age, prior comorbidities, use of drugs, cause of hospital admission and serum sodium levels (SNa) before and following PN initiation. Parameters for study of hyponatremia were also included, such as clinical volemia, the presence of pain, nausea, gastrointestinal losses, edema, measurement of creatinine, plasma and urine Osmolality, urinary electrolytes, cortisolemia, and thyroid stimulating hormone.
Results: 59.6% were men. The average age was 66.9 (S.D. 11.5). 53.2% had hyponatremia before PN initiation. All patients had diagnostic criteria for the SIAD. Most probable etiologies of SIAD were: malignant disease (55.3%), drugs (23.4%: antidepressants, pregabalin/gabapentin, opiatas,\..), abdominal disorders (10.6%), pulmonary disorders (2.1%), and idiopathic (2.1%). Etiology of SIAD could not be assessed in 3 patients. No patient had SIAD caused by neurologic disorder.
Conclusions: The diagnostic approach of etiology of SIAD is complex. Multiple clinical factors must be taken into account. In our series of patients receiving PN, paraneoplasic secretion of antidiuretic hormone was the most frequent cause of SIAD-induced hyponatremia. Other etiologies were different than in the general population, probably related to specific clinical features of patients on PN.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more