EYES2023 ESE Young Endocrinologists and Scientists (EYES) 2023 Oral communication 2: Neuroendocrinology (6 abstracts)
Effect of protein supplementation on plasma sodium levels in the syndrome of inappropriate antidiuresis – a monocentric open-label proof-of-concept study – the treasure study
Sophie Monnerat 1 , Cihan Atila 2 , Fabienne Baur 1 , Joyce Santos de Jesus 3 , Julie Refardt 4 , Michael Dickenmann 5 & Mirjam Christ-Crain 6
1University Hospital Basel, Department of Endocrinology, Diabetology and Metabolism, Basel, Switzerland; 2University Hospital Basel, 1 Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland; 2 Department of Clinical Research, University of Basel, Basel, Switzerland;, Department of Endocrinology, Diabetology and Metabolism, Basel, Switzerland; 3Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland; 4Universitätsspital Basel, Department of Clinical Research, University of Basel, Basel, Switzerland, Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland, Basel, Switzerland; 5Universitätsspital Basel, Clinic for Transplantation Immunology and Nephrology, Basel, Switzerland; 6University Hospital Basel, Department of Clinical Research, University of Basel, Basel, Switzerland, Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland, Basel, Switzerland.
Background: The syndrome of inappropriate antidiuresis (SIAD) can be treated with oral urea. Proteins are metabolized into urea by the liver. We hypothesized that dietary protein could increase free water clearance through urea-induced osmotic diuresis.ObjectivesTo investigate the effect of protein supplementation on plasma sodium levels in chronic SIAD.
Methods: This is a monocentric open-label proof-of-concept trial conducted at the University Hospital of Basel, Switzerland, between 10/2021 and 02/2023. Adult outpatients with chronic SIAD of any etiology were eligible. Patients received 90 g protein daily for 7 days in the form of protein powder dissolved in a maximum of 1l of liquid of choice. After a wash-out period of at least a week, patients received 30 g of oral urea daily for 7 days. The primary endpoint was the increase in sodium levels from baseline to the end of the 7-day protein supplementation.
Results: Seventeen patients were included (14 females, median age 68 [61, 79]). After 7 days of 90 g daily protein supplementation (n=17), plasma sodium increased from 131 [129, 133] to 133 [132, 137], i.e., by a median of 3 mmol/l [0, 5] (P=0.01). Plasma urea increased by 3 mmol/l [1.7, 4.9] (P<0.01) and urine urea to creatinine ratio by 21.2 mmol/mmol [6.2, 29.1] (P<0.01). After 7 days of 30 g oral urea (n=10), plasma sodium increased from 132 [130, 133] to 134 [131, 136], i.e., by a median of 2 mmol/l [1, 3] (P=0.06). Plasma urea increased by 5.8 mmol/l [2.7, 9.2] (P<0.01) and urine urea to creatinine ratio by 31.0 mmol/mmol [18.7, 45.1] (P<0.01).
Conclusions: Our findings suggest that protein supplementation with protein powder increases plasma sodium levels in patients with chronic SIAD through protein-induced ureagenesis and osmotic diuresis.
Volume 93
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Endocrine Abstracts
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