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Erschienen in: Journal für Klinische Endokrinologie und Stoffwechsel 2/2018

06.03.2018 | Originalien

Acht brennende Fragen und Antworten zum Thema Hyponatriämie

verfasst von: Dr. Christoph Schwarz, Dr. Stephan Schoiswohl

Erschienen in: Journal für Endokrinologie, Diabetologie und Stoffwechsel | Ausgabe 2/2018

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Zusammenfassung

Das Thema Hyponatriämie ist von großer klinischer Relevanz in der täglichen Praxis. Es ist als „Symptom“ vieler unterschiedlicher Organerkrankungen zu sehen. Neben endokrinologischen sind auch nephrologische, pulmologische, kardiologische, neuropsychiatrische und gastrointestinale/hepatale Ursachen von Relevanz. Zusätzlich kann auch eine inadäquate Behandlung des Wasser- und Volumenhaushalts (Infusion oder diuretische Therapie) zu einer Hyponatriämie führen. Aktuelle europäische bzw. amerikanische Empfehlungen zur Diagnose und Therapie der Hyponatriämie können die Behandlung erleichtern. Diese Richtlinien sind wertvoll für die tägliche Praxis, können aber nicht alle Aspekte abdecken. Deshalb ist es wichtig, auch die physiologischen Zusammenhänge in der Entstehung und Aufrechterhaltung einer Hyponatriämie zu verstehen.
Literatur
1.
Zurück zum Zitat Spasovski G, Vanholder R, Allolio B, Annane D, Ball S, Bichet D, Decaux G, Fenske W, Hoorn EJ, Ichai C, Joannidis M, Soupart A, Zietse R, Haller M, van der Veer S, Van Biesen W, Nagler E, Guideline Development Group (2014) Clinical practice guideline on diagnosis and treatment of hyponatraemia. Nephrol Dial Transplant 29(Suppl 2):i1–i39CrossRefPubMed Spasovski G, Vanholder R, Allolio B, Annane D, Ball S, Bichet D, Decaux G, Fenske W, Hoorn EJ, Ichai C, Joannidis M, Soupart A, Zietse R, Haller M, van der Veer S, Van Biesen W, Nagler E, Guideline Development Group (2014) Clinical practice guideline on diagnosis and treatment of hyponatraemia. Nephrol Dial Transplant 29(Suppl 2):i1–i39CrossRefPubMed
2.
Zurück zum Zitat Verbalis JG, Goldsmith SR, Greenberg A, Korzelius C, Schrier RW, Sterns RH, Thompson CJ (2013) Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med 126:1–42CrossRef Verbalis JG, Goldsmith SR, Greenberg A, Korzelius C, Schrier RW, Sterns RH, Thompson CJ (2013) Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med 126:1–42CrossRef
3.
Zurück zum Zitat Liamis G, Filippatos TD, Elisaf MS (2016) Thiazide-associated hyponatremia in the elderly: what the clinician needs to know. J Geriatr Cardiol 13:175–182PubMedPubMedCentral Liamis G, Filippatos TD, Elisaf MS (2016) Thiazide-associated hyponatremia in the elderly: what the clinician needs to know. J Geriatr Cardiol 13:175–182PubMedPubMedCentral
4.
Zurück zum Zitat Szatalowicz VL, Miller PD, Lacher JW, Gordon JA, Schrier RW (1979) Comparative effect of diuretics on renal water excretion in hyponatraemic oedematous disorders. Clin Sci 62:235–238CrossRef Szatalowicz VL, Miller PD, Lacher JW, Gordon JA, Schrier RW (1979) Comparative effect of diuretics on renal water excretion in hyponatraemic oedematous disorders. Clin Sci 62:235–238CrossRef
5.
Zurück zum Zitat Kamel KS, Halperin ML (2012) The importance of distal delivery of filtrate and residual water permeability in the pathophysiology of hyponatremia. Nephrol Dial Transplant 27:872–875CrossRefPubMed Kamel KS, Halperin ML (2012) The importance of distal delivery of filtrate and residual water permeability in the pathophysiology of hyponatremia. Nephrol Dial Transplant 27:872–875CrossRefPubMed
6.
Zurück zum Zitat Berl T (2008) Impact of solute intake on urine flow and water excretion. J Am Soc Nephrol 19:1076–1078CrossRefPubMed Berl T (2008) Impact of solute intake on urine flow and water excretion. J Am Soc Nephrol 19:1076–1078CrossRefPubMed
7.
Zurück zum Zitat Windpessl M, Schwarz C, Wallner M (2017) “Bowel prep hyponatremia”—a state of acute water intoxication facilitated by low dietary solute intake: case report and literature review. Bmc Nephrol 18:54CrossRefPubMedPubMedCentral Windpessl M, Schwarz C, Wallner M (2017) “Bowel prep hyponatremia”—a state of acute water intoxication facilitated by low dietary solute intake: case report and literature review. Bmc Nephrol 18:54CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Crowe MJ, Forsling ML, Rolls BJ, Phillips PA, Ledingham JG, Smith RF (1987) Altered water excretion in healthy elderly men. Age Ageing 16:285–293CrossRefPubMed Crowe MJ, Forsling ML, Rolls BJ, Phillips PA, Ledingham JG, Smith RF (1987) Altered water excretion in healthy elderly men. Age Ageing 16:285–293CrossRefPubMed
9.
Zurück zum Zitat Alcázar Arroyo R (2008) Electrolyte and acid-base balance disorders in advanced chronic kidney disease. Nefrologia 28(Suppl 3):87–93PubMed Alcázar Arroyo R (2008) Electrolyte and acid-base balance disorders in advanced chronic kidney disease. Nefrologia 28(Suppl 3):87–93PubMed
10.
Zurück zum Zitat Wu M‑Y, Chen T‑T, Chen Y‑C, Tarng D‑C, Wu Y‑C, Lin H‑H, Tu Y‑K (2017) Effects and safety of oral tolvaptan in patients with congestive heart failure: a systematic review and network meta-analysis. PLoS ONE 12:e184380CrossRefPubMedPubMedCentral Wu M‑Y, Chen T‑T, Chen Y‑C, Tarng D‑C, Wu Y‑C, Lin H‑H, Tu Y‑K (2017) Effects and safety of oral tolvaptan in patients with congestive heart failure: a systematic review and network meta-analysis. PLoS ONE 12:e184380CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Tzoulis P, Carr H, Bagkeris E, Bouloux PM (2017) Improving care and outcomes of inpatients with syndrome of inappropriate antidiuresis (SIAD): a prospective intervention study of intensive endocrine input vs. routine care. Endocrine 55:539–546CrossRefPubMed Tzoulis P, Carr H, Bagkeris E, Bouloux PM (2017) Improving care and outcomes of inpatients with syndrome of inappropriate antidiuresis (SIAD): a prospective intervention study of intensive endocrine input vs. routine care. Endocrine 55:539–546CrossRefPubMed
13.
Zurück zum Zitat Leng G, Brown CH, Russell JA (1999) Physiological pathways regulating the activity of magnocellular neurosecretory cells. Prog Neurobiol 57:625–655CrossRefPubMed Leng G, Brown CH, Russell JA (1999) Physiological pathways regulating the activity of magnocellular neurosecretory cells. Prog Neurobiol 57:625–655CrossRefPubMed
14.
Zurück zum Zitat Oh GJ, Sutherland SM (2016) Perioperative fluid management and postoperative hyponatremia in children. Pediatr Nephrol 31:53–60CrossRefPubMed Oh GJ, Sutherland SM (2016) Perioperative fluid management and postoperative hyponatremia in children. Pediatr Nephrol 31:53–60CrossRefPubMed
15.
Zurück zum Zitat Sterns RH, Hix JK (2009) Overcorrection of hyponatremia is a medical emergency. Kidney Int 76:587–589CrossRefPubMed Sterns RH, Hix JK (2009) Overcorrection of hyponatremia is a medical emergency. Kidney Int 76:587–589CrossRefPubMed
16.
Zurück zum Zitat Perianayagam A, Sterns RH, Silver SM, Grieff M, Mayo R, Hix J, Kouides R (2008) DDAVP is effective in preventing and reversing inadvertent overcorrection of hyponatremia. Clin J Am Soc Nephrol 3:331–336CrossRefPubMedPubMedCentral Perianayagam A, Sterns RH, Silver SM, Grieff M, Mayo R, Hix J, Kouides R (2008) DDAVP is effective in preventing and reversing inadvertent overcorrection of hyponatremia. Clin J Am Soc Nephrol 3:331–336CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Gankam Kengne F, Soupart A, Pochet R, Brion J‑P, Decaux G (2009) Re-induction of hyponatremia after rapid overcorrection of hyponatremia reduces mortality in rats. Kidney Int 76:614–621CrossRefPubMed Gankam Kengne F, Soupart A, Pochet R, Brion J‑P, Decaux G (2009) Re-induction of hyponatremia after rapid overcorrection of hyponatremia reduces mortality in rats. Kidney Int 76:614–621CrossRefPubMed
18.
Zurück zum Zitat Sood L, Sterns RH, Hix JK, Silver SM, Chen L (2013) Hypertonic saline and desmopressin: a simple strategy for safe correction of severe hyponatremia. Am J Kidney Dis 61:571–578CrossRefPubMed Sood L, Sterns RH, Hix JK, Silver SM, Chen L (2013) Hypertonic saline and desmopressin: a simple strategy for safe correction of severe hyponatremia. Am J Kidney Dis 61:571–578CrossRefPubMed
19.
Zurück zum Zitat Baumgarten R, van de Pol MH, Deen PM, van Os CH, Wetzels JF (2000) Dissociation between urine osmolality and urinary excretion of aquaporin-2 in healthy volunteers. Nephrol Dial Transplant 15:1155–1161CrossRefPubMed Baumgarten R, van de Pol MH, Deen PM, van Os CH, Wetzels JF (2000) Dissociation between urine osmolality and urinary excretion of aquaporin-2 in healthy volunteers. Nephrol Dial Transplant 15:1155–1161CrossRefPubMed
20.
Zurück zum Zitat Roussel R, Fezeu L, Marre M, Velho G, Fumeron F, Jungers P, Lantieri O, Balkau B, Bouby N, Bankir L, Bichet DG (2014) Comparison between copeptin and vasopressin in a population from the community and in people with chronic kidney disease. J Clin Endocrinol Metab 99:4656–4663CrossRefPubMed Roussel R, Fezeu L, Marre M, Velho G, Fumeron F, Jungers P, Lantieri O, Balkau B, Bouby N, Bankir L, Bichet DG (2014) Comparison between copeptin and vasopressin in a population from the community and in people with chronic kidney disease. J Clin Endocrinol Metab 99:4656–4663CrossRefPubMed
21.
Zurück zum Zitat Fenske W, Störk S, Blechschmidt A, Maier SGK, Morgenthaler NG, Allolio B (2009) Copeptin in the differential diagnosis of hyponatremia. J Clin Endocrinol Metab 94:123–129CrossRefPubMed Fenske W, Störk S, Blechschmidt A, Maier SGK, Morgenthaler NG, Allolio B (2009) Copeptin in the differential diagnosis of hyponatremia. J Clin Endocrinol Metab 94:123–129CrossRefPubMed
22.
Zurück zum Zitat Fenske WK, Christ-Crain M, Hörning A, Simet J, Szinnai G, Fassnacht M, Rutishauser J, Bichet DG, Störk S, Allolio B (2014) A copeptin-based classification of the osmoregulatory defects in the syndrome of inappropriate antidiuresis. J Am Soc Nephrol 25:2376–2383CrossRefPubMedPubMedCentral Fenske WK, Christ-Crain M, Hörning A, Simet J, Szinnai G, Fassnacht M, Rutishauser J, Bichet DG, Störk S, Allolio B (2014) A copeptin-based classification of the osmoregulatory defects in the syndrome of inappropriate antidiuresis. J Am Soc Nephrol 25:2376–2383CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Timper K, Fenske W, Kühn F, Frech N, Arici B, Rutishauser J, Kopp P, Allolio B, Stettler C, Müller B, Katan M, Christ-Crain M (2015) Diagnostic accuracy of copeptin in the differential diagnosis of the polyuria-polydipsia syndrome: a prospective multicenter study. J Clin Endocrinol Metab 100:2268–2274CrossRefPubMed Timper K, Fenske W, Kühn F, Frech N, Arici B, Rutishauser J, Kopp P, Allolio B, Stettler C, Müller B, Katan M, Christ-Crain M (2015) Diagnostic accuracy of copeptin in the differential diagnosis of the polyuria-polydipsia syndrome: a prospective multicenter study. J Clin Endocrinol Metab 100:2268–2274CrossRefPubMed
24.
Zurück zum Zitat Hus-Citharel A, Bodineau L, Frugière A, Joubert F, Bouby N, Llorens-Cortes C (2014) Apelin counteracts vasopressin-induced water reabsorption via cross talk between apelin and vasopressin receptor signaling pathways in the rat collecting duct. Endocrinology 155:4483–4493CrossRefPubMed Hus-Citharel A, Bodineau L, Frugière A, Joubert F, Bouby N, Llorens-Cortes C (2014) Apelin counteracts vasopressin-induced water reabsorption via cross talk between apelin and vasopressin receptor signaling pathways in the rat collecting duct. Endocrinology 155:4483–4493CrossRefPubMed
25.
Zurück zum Zitat Azizi M, Iturrioz X, Blanchard A, Peyrard S, Mota ND, Chartrel N, Vaudry H, Corvol P, Llorens-Cortes C (2008) Reciprocal regulation of plasma apelin and vasopressin by osmotic stimuli. J Am Soc Nephrol 19:1015–1024CrossRefPubMedPubMedCentral Azizi M, Iturrioz X, Blanchard A, Peyrard S, Mota ND, Chartrel N, Vaudry H, Corvol P, Llorens-Cortes C (2008) Reciprocal regulation of plasma apelin and vasopressin by osmotic stimuli. J Am Soc Nephrol 19:1015–1024CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Blanchard A, Steichen O, De Mota N, Curis E, Gauci C, Frank M, Wuerzner G, Kamenicky P, Passeron A, Azizi M, Llorens-Cortes C (2013) An abnormal apelin/vasopressin balance may contribute to water retention in patients with the syndrome of inappropriate antidiuretic hormone (SIADH) and heart failure. J Clin Endocrinol Metab 98:2084–2089CrossRefPubMed Blanchard A, Steichen O, De Mota N, Curis E, Gauci C, Frank M, Wuerzner G, Kamenicky P, Passeron A, Azizi M, Llorens-Cortes C (2013) An abnormal apelin/vasopressin balance may contribute to water retention in patients with the syndrome of inappropriate antidiuretic hormone (SIADH) and heart failure. J Clin Endocrinol Metab 98:2084–2089CrossRefPubMed
Metadaten
Titel
Acht brennende Fragen und Antworten zum Thema Hyponatriämie
verfasst von
Dr. Christoph Schwarz
Dr. Stephan Schoiswohl
Publikationsdatum
06.03.2018
Verlag
Springer Vienna
Erschienen in
Journal für Endokrinologie, Diabetologie und Stoffwechsel / Ausgabe 2/2018
Print ISSN: 3004-8915
Elektronische ISSN: 3004-8923
DOI
https://doi.org/10.1007/s41969-018-0021-z

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