Modern etiopathogenesis, diagnostics and therapy of the hormonally evoked hyponatraemia are summarized mainly for clinicians. Pathophysiologically, hyponatraemias are classified into two groups: water intoxication and sodium depletion. The most important representatives of these disorders are discussed: syndrome of inappropriate ADH secretion (SIADH) and Addison's disease. The diagnosis of SIADH is based on the exclusion of other hyponatraemic conditions; the decreased uric acid and increased vasopressin and atriopeptin levels in the blood are of pathognomic value. Acute SIADH necessitates emergency care with gradual restoration of normal osmotic milieu (1 mmol/l/hr increase rate of serum sodium). In the treatment of chronic SIADH, besides the restriction of fluid intake, demeclocycline or lithium may be recommended; a new forthcoming therapeutic era may be opened up by the receptor antagonists vasopressin. Autoimmune adrenalitis has become the leading pathogenetic background of Addison's disease (75 per cent), the tuberculotic origin occurs in 20 per cent of the cases. An evening dose of dexamethasone with longer glucocorticoid action in combination with bid administration of tha mineralocorticoid fludrocortisone is proposed for adrenocortical hormone replacement therapy.
|Translated title of the contribution||Endocrine hyponatraemias|
|Number of pages||7|
|Publication status||Published - Dec 1 1995|
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