Оглавление
Группа авторов. Disorders of Fluid and Electrolyte Metabolism
Frontiers of Hormone Research
Disorders of Fluid and Electrolyte Metabolism
Contents
Historical Aspects of Hyponatremia
Early Publications and Theories
Early Descriptions of SIAD
Measurement of Plasma Vasopressin Levels
Development of Animal Models of Hyponatremia
Recent Advances
References
Physiology and Pathophysiology of Water Homeostasis
Abstract
Physiology of Water Homeostasis. Introduction
Plasma Tonicity
Determinants of Plasma Tonicity
Determinants of Plasma Sodium Concentration
Water Balance
Tonicity Sensing Mechanisms
Thirst
Vasopressin
Renal Handling of Water
Loop of Henle
Distal Tubule and CDs
Mechanisms of Urinary Concentration
Homeostatic Response to Changes in Plasma Tonicity
Pathophysiology of Disorders of Water Homeostasis: Hyponatremia
Increased Free Water Intake
Decreased Renal Free Water Excretion
Decreased Glomerular Filtration
Decreased Solute Intake
Increased Vasopressin Activity
Decreased EABV
Syndrome of Inappropriate ADH Secretion
Cortisol Deficiency
Thiazide-Induced Hyponatremia
References
Etiology and Epidemiology of Hyponatremia
Abstract
Etiology of Hyponatremia
Epidemiology of Hyponatremia
Hyponatremia in Geriatric Patients
Hyponatremia in the Emergency Department
Hyponatremia in the Postoperative Setting
Hyponatremia in the Intensive Care Setting
Conclusion
References
Morbidity and Mortality of Hyponatremia
Abstract
Introduction
Morbidity of Hyponatremia. General Considerations
Acute Hyponatremia
Chronic Hyponatremia
LOS in the Hospital
Hyponatremia and Mortality
Conclusions
Acknowledgements
References
Hyponatremia Is Linked to Bone Loss, Osteoporosis, Fragility and Bone Fractures
Abstract
Introduction: Osteoporosis and Bone Fragility
Hyponatremia Linked to Osteoporosis and Bone Fragility: Human Studies
Mechanisms of Hyponatremia-Induced Osteoporosis: Animal Studies
Mechanisms of Hyponatremia-Induced Osteoporosis: Cellular Studies
Summary: Compelling Questions and Future Directions
References
Euvolemic Hyponatremia Secondary to the Syndrome of Inappropriate Antidiuresis
Abstract
SIAD: Diagnosis and Evaluation
SIAD: Treatment
Current Therapies
Efficacy of Different Treatments for Hyponatremia
Hyponatremia Treatment Guidelines
Levels of Symptoms
Monitoring Serum Sodium Concentration in Hyponatremic Patients
Long-Term Treatment of Chronic Hyponatremia
Primary Polydipsia
References
Hyponatremia and Glucocorticoid Deficiency
Abstract
Introduction
Pathophysiology
Prevalence
Differential Diagnosis
Management
Conclusion
References
Hypovolemic Hyponatremia
Abstract
Pathophysiology of Hypovolemic Hyponatremia
Etiologies of Hypovolemic Hyponatremia. Gastrointestinal Tract Losses
Endocrinopathies
Thiazide Diuretics
Exercise-Associated Hyponatremia
Methylenedioxymethamphetamine, Ecstasy
Treatment of Hypovolemic Hyponatremia
Conclusions
References
Hypervolemic Hyponatremia (Liver)
Abstract
Types of Hyponatremia in Cirrhosis
Pathophysiology
Clinical Significance
Neurological Manifestations
Other Complications of Cirrhosis
Quality of Life and Prognosis
Management of Hypervolemic Hyponatremia in Cirrhosis
Fluid Restriction
Sodium Chloride
Albumin
Pharmacological Therapy: Vaptans
Grant Support and Acknowledgements
References
Hypervolemic Hyponatremia in Heart Failure
Abstract
Introduction
Pathophysiology
Clinical Evidence for Elevated AVP Levels in HF and/or LV Dysfunction
Hemodynamic Effects of AVP in HF
Role of AVP in Water Balance and Hyponatremia in HF
Clinical Presentation and Significance of Hyponatremia in HF
Evaluation of Hyponatremia in HF
Treatment
Fluid Restriction
Loop Diuretics
AVP Receptor Antagonism
Renin-Angiotensin System Blockers
Vasodilators and Inotropes
Hypertonic Saline
Potential Adverse Effects of Hyponatremia Treatment in HF
Conclusion
References
Adverse Consequences of Overly-Rapid Correction of Hyponatremia
Abstract
Brain Adaptations to Hyponatremia and Its Correction
Rapid Correction of Hyponatremia and Central Pontine Myelinolysis
Osmotic Demyelination Syndrome and the Clinical Manifestations of Myelinolysis
Risk Factors for Osmotic Demyelination
Avoiding Overly Rapid Correction of Hyponatremia
References
Hyponatremia in Neurosurgical Patients
Abstract
Introduction
Incidence of Hyponatremia in Neurosurgical Patients
Pathophysiology of Hyponatremia in Neurosurgical Patients
Hyponatremia following TBI
Hyponatremia Following SAH
Hyponatremia Following Pituitary Surgery
Management of Hyponatremia in the Neurosurgical Patient
Conclusion
Disclosure Statement
References
Hyponatremia in Oncology Patients
Abstract
Introduction and Background
Diagnostic Workup
Treatment of Hyponatremia in Cancer Patients
References
Hyponatremia-Inducing Drugs
Abstract
Diuretics
Psychotropic Agents
Anticonvulsants
Antineoplastic and Immunomodulating Agents
Opioids
Amphetamines
Angiotensin-Converting Enzyme Inhibitors
Amiodarone
Antibiotic Therapy
Proton Pump Inhibitors
Theophylline
Hypoglycemic Agents
Non-Steroidal Anti-Inflammatory Drugs
Exogenous Administration of Vasopressin Analogs
Mannitol
Immune Globulin
Bowel Cleansing Agents
Management of Drug-Induced Hyponatremia
References
Exercise-Associated Hyponatremia
Abstract
Introduction
Incidence and Risk Factors
Pathophysiology
Diagnosis
Signs and Symptoms
Treatment
Prevention
Summary
References
The Diagnostic Approach to the Patient with Hyponatremia: Are the Correct Investigations Being Done?
Abstract
Introduction
Clinical Evaluation of the Hyponatremic Patient
Clinical Examination
Urine Electrolytes
Urine Osmolality
Fractional Excretion of Uric Acid
Other Biochemical Parameters
Response to Intravenous Isotonic Saline Challenge
Additional Investigations Once the Diagnosis of SIAD is Established
Are Current Routine Investigations of Hyponatremia Adequate?
Barriers to Optimal Investigation and Diagnosis of Hyponatremia
References
Future of Hyponatremia Research
Basic/Translational Studies That Have High Priority. Mechanisms Responsible for Bone Loss with Chronic Hyponatremia
Mechanisms Responsible for Gait Instability and Falls with Chronic Hyponatremia
Effects of Hyponatremia on Malignant Cells
Effects of Chronic Hyponatremia on other Body Organs
Clinical Research Studies That Have High Priority. Improvement of Symptomatic Hyponatremia
Improvement of Clinical Outcomes
Effectiveness and Safety of Different Treatments for Hyponatremia
Prevention of Falls, Osteoporosis, and Fractures
Improvement of Quality of Life
Reduction of Hospital Resource Utilization
Conclusions
Author Index
Subject Index
