Last update:
25-Nov-2018

Despite hyponatremia being common, and of interest to general practitioners, physicians and surgeons, it is often poorly managed because of lack of a systematic approach to its investigation and treatment. New insight is now available into the effects of chronic hyponatremia on, for example, subtle neurological dysfunction, falls, osteoporosis, osteoporotic fractures and mortality. Approximately half of the cases of chronic hyponatremia are due to the syndrome of inappropriate anti-diuretic hormone secretion (SIADH). It is crucial that this diagnosis is considered and a diagnostic algorithm is strictly followed prior to initiating treatment for hyponatremia, because the therapeutic approach for SIADH differs from that for other forms of hyponatremia. Moreover, once treatment has been initiated it becomes difficult to make sense of some of the tests commonly used to diagnose SIADH. V₂-receptor antagonists have revolutionized the treatment of SIADH, and experience of the use of these agents has now been documented. These agents are not indicated for the majority of forms of hyponatremia, and their use must be restricted to the selected population with confirmed SIADH.

Key words: Complications, Diagnosis, Hyponatremia, Management, Syndrome of inappropriate antidiuretic hormone secretion (SIADH).