Endocrine Abstracts

Introduction: Hypoaldosteronism (HA), a cause of hypovolemic hyponatremia (HN) with urinary(U) sodium(Na) loss, is often underdiagnosed. We studied 28 patients with an episode of HA-induced moderate/severe hyponatremia.Methods: Retrospective 2012–2015. In all patients, Nadir(N) serum(S) Na <130 mmol/l (corrected for total proteins and glycemia), low internal yugular venous pressure, low ocular pressure. Addison’s Disease ruled (ACTH, cortis...

Introduction: ESE guidelines state a risk for overcorrection of serum sodium levels (SNa) with vaptans. We present the results of our protocol for initiation of tolvaptan(TV) therapy in SIADH.Methods: Retrospective (2011–15). 86 patients with SIADH-induced mild/moderate hyponatremia received TV:7.5 mg day 1, ad-libitum liquids, no other Na-raising therapies. Conventional hospitalization (CH):66/86, day hospital (DH):20/86. Glycemia-corrected SNa det...

Introduction: Some authors consider aldosteronism to be a spectrum, ranging from aldosterone-associated (or low-renin) hypertension (AAH) to primary hyperaldosteronism (PHA) due to bilateral adrenal hyperplasia. Thus, blood pressure (BP) response to mineralocorticoid-receptor blockade (MRB) could be similar.Methods: Retrospective analysis of 60 patients. Screening per Endocrine Society guidelines, positive screening: aldosterone (pg/ml) to direct-renin (...

Introduction: Furosemide can be used in the treatment of SIADH. However, to be effective, renal medulla osmolality (OsmRM) as reflected in urinary osmolality (UOSM) must be high. Sodium is the most important contributor to OsmRM, which increases following the administration of oral salt. We analyze the use of an oral salt load followed by furosemide for the acute/short-term treatment of euvolemic SIADH hyponatremia.Method...

Introduction: Chronic tolvaptan (TV) therapy has been found to be safe and effective in the treatment of chronic SIADH. However, experience with modification of doses over time is limited.Methods: We conducted a retrospective analysis of weekly TV doses (mg) in 41 patients with chronic SIADH treated for a minimum of 3 months, seen a week following discharge and monthly thereafter. Serum sodium (SNa) goal was 137–140 mmol/l, with 50% TV dose reductio...

Introduction: Hyponatremia is common in the emergency room, albeit frequently overlooked. Our objective was to describe the characteristics of hyponatremia in a cohort of emergency room patients, and evaluate how hyponatremia was studied and followed up.Material and methods: We studied all 211 patients under 70 years-of-age who presented/developed non-translocational hyponatremia (serum sodium (SNa) <135 mmol/l) during the first 48 h of their stay at...