Endocrine Abstracts

Context: Fluid restriction (FR) is recommended as first line therapy for SIAD by both the European1 and the American guidelines2 for management of SIAD. Not all patients respond to FR however, and the American guidelines have identified clinical predictors of failure to respond to FR. These include 1.Urine osmolality (UOsm) >500 mOsm/Kg 2. Furst formula (ratio UNa+UK/pNa) > 1, and 3. 24 hour-urine volume<1500 mlObjective...

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...

Isolated acquired hypoaldosteronism (HA) is considered to be a cause of hypovolemic hyponatremia (HH) with urinary sodium loss (UNaL) and hyperkalemia/upper-limit serum potassium (SK). However, some authors question the presentation of hyponatremia of these characteristics in the absence of Addison’s disease (AD).We present a series of patients with HA. Methods: Aretrospective study of 70 cases of HH with UNaL (UNa > 25 mmol/l) and SK ≥ 5 mmol/l or in...

Introduction: Endocrine Society guideline indications for screening (EGS) of hypertensive patients for hyperaldosteronism are not universally followed in clinical Endocrinology. We present a series of patients with hyperaldosteronism, diagnosed following strict EGS compliance.Methods: Retrospective. Following compliance with EGS in all patients attended in a general Endocrinology outpatient clinic, 70 hypertensive patients were diagnosed with hyperaldost...

Objective: To study the association between the state of iodine nutrition, and the risk of total and cause mortality in a representative sample of the Spanish adult population.Design: Longitudinal observational study to estimate mortality risk according to urinary iodine (UI) concentrations using a sample of 4370 subjects >18 years representative of the Spanish adult population participating in the national study [email protected] (2008–2010). We used ...

Measurement of electrical impedance has been proposed as a way to determine whether a hyponatremic patient is hypovolemic or euvolemic. We compare the usefulness of the physical examination (PE) with bioimpedance for determination of volemia in an outpatient hyponatremia clinic.Method: Descriptive prospective analysis. 11 patients attended at the hyponatremia clinic of a tertiary hospital were evaluated. Impedance was measured by a SECA, indicating the p...

Introduction: Hyperaldosteronism can induce elevated parathyroid hormone (PTH) levels, presumably by increasing calciuria. Furthermore, PTH stimulates aldosterone secretion in vitro, and increases angiotensin–II-stimulated aldosterone release. In a patient with hyperaldosteronism and hyperparathyroidism, PTH receptors were detected in aldosteronoma tissue. We present three patients sent to an endocrinologist for treatment/follow-up of primary hyperparathyroidism,...