Inappropriate ADH Syndrome (SIADH)

A condition of HYPONATREMIA and renal salt loss attributed to overexpansion of BODY FLUIDS resulting from sustained release of ANTIDIURETIC HORMONES which stimulates renal resorption of water. It is characterized by normal KIDNEY function, high urine OSMOLALITY, low serum osmolality, and neurological dysfunction. Etiologies include ADH-producing neoplasms, injuries or diseases involving the HYPOTHALAMUS, the PITUITARY GLAND, and the LUNG. This syndrome can also be drug-induced.

Also Known As:

Networked: 1644 relevant articles (86 outcomes, 84 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Hyponatremia
2.	Neoplasms (Cancer)
3.	Polydipsia
4.	Heart Failure
5.	Wasting Syndrome (Wasting Disease)

Experts

1.	Decaux, Guy: 17 articles (01/2022 - 01/2004)
2.	Verbalis, Joseph G: 16 articles (04/2019 - 01/2002)
3.	Maesaka, John K: 10 articles (01/2021 - 02/2009)
4.	Imbriano, Louis J: 7 articles (01/2021 - 11/2009)
5.	Musch, Wim: 7 articles (09/2019 - 01/2004)
6.	Liamis, George: 6 articles (11/2020 - 06/2002)
7.	Peri, Alessandro: 6 articles (01/2017 - 03/2012)
8.	Ishikawa, San-E: 5 articles (01/2021 - 08/2004)
9.	Miyawaki, Nobuyuki: 5 articles (03/2020 - 02/2009)
10.	Thompson, C J: 5 articles (01/2019 - 11/2004)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Inappropriate ADH Syndrome:

1.	TolvaptanFDA Link 11/06/2017 - "This study confirms the safety and efficacy of Tolvaptan in the treatment of SIADH-related significant, symptomatic hyponatraemia when used under specialist guidance and strict monitoring. " 11/01/2018 - "Tolvaptan could be a good, safe, and effective treatment option in pediatric SIADH cases that are resistant to treatment. " 11/01/2018 - "Here we present a pediatric case of SIADH that was resistant to treatment with fluid restriction and hypertonic saline infusion and was treated successfully with tolvaptan. " 07/01/2020 - "Tolvaptan at a moderate dose is more effective than fluid restriction in the treatment of SIADH. " 10/17/2023 - "This case report represents the first documented evidence of the therapeutic efficacy of tolvaptan in treating SIADH in a dog."
2.	Vasopressins (Vasopressin)IBA 12/01/2002 - "Serum antidiuretic hormone (ADH) remained elevated at 0.59 pg/ml in spite of a significant reduction in serum osmolality to 254 mosm/kg. He had no organic disease likely to cause SIADH. " 05/01/2005 - "The pharmacologic blockade of AVP stimulus in SIADH limits its therapeutic efficacy by discontinuing the vasopressin escape, and the selective inhibition of rBSC1 complements this limitation." 01/01/2017 - "The aims of the current study were to determine the distribution of aetiologies for the drug-induced syndrome of inappropriate antidiuretic hormone secretion (SIADH) in hospitalized patients, and to characterize them according to the different drug groups. " 12/01/2014 - "The goals of this study were to assess the incidence of and risk factors for the syndrome of inappropriate antidiuretic hormone secretion (SIADH) in patients following transsphenoidal surgery (TSS), and to validate the effectiveness of early prophylactic restriction of water intake. " 04/01/2014 - "This study presents the first reported case of combined SmCC and SqCC originating from the sinonasal tract accompanied by syndrome of inappropriate secretion of antidiuretic hormone (SIADH). "
3.	SodiumIBA 01/01/2023 - "The most common cause of serum sodium abnormality is SIADH, and an early diagnosis for target treatment is paramount to prevent delayed symptoms and complications." 03/01/2016 - "Patients with CSW had significantly greater natriuresis compared with those with SIADH (median urine sodium 211 vs 28 mEq/L, p = 0.01). " 04/01/2011 - "In short and long term studies, tolvaptane has been shown to be effective in raising serum sodium levels in a predictable fashion in patients with SIADH with only few side effects, when serum sodium was frequently monitored and dosage of tolvaptans was properly adjusted. " 01/01/2018 - "Serum sodium level was improved with treatment of SHP, which suggested the relevance between SHP and SIADH." 01/01/2022 - "More studies are needed to delineate treatment pathways of patients with very high urine osmolality and urine sodium concentrations in SIADH."
4.	Urea (Carbamide)FDA LinkGeneric 07/01/2008 - "In SIADH, urea is typically low; this is less specific for elderly patients, for whom lower clearance of urea accounts for higher values. " 01/01/2020 - "Our data show that urea is an effective treatment for hospitalised patients with SIADH. " 01/01/1993 - "Oral urea, even during long periods, is a safe and effective therapeutic approach for patients with chronic SIADH which is not controlled by water restriction alone." 10/02/2023 - "In this systematic review of the use of urea in SIADH and despite the lack of randomized clinical trials, lower-quality evidence was identified that suggests that urea may be an effective, safe, and inexpensive treatment modality that warrants further exploration." 10/02/2023 - "Twenty-three studies involving 537 patients with SIADH were included, of which 462 were treated with urea. "
5.	SaltsIBA 05/01/2011 - "Results for the SIADH subgroup were analogous to those of the combined SALT population regarding efficacy and safety but demonstrated a greater improvement in the physical component of the SF-12 Health Survey than in the full mixed etiology SALT patient group." 07/01/2008 - "Although the differential diagnosis with other causes of hypotonicity such as salt depletion is sometimes challenging, some simple and readily available biologic parameters can be helpful in the diagnosis of SIADH. " 01/01/2023 - "A study of 62 hyponatremic patients from the general medical wards of the hospital identified 17 (27%) to have SIADH, 19 (31%) with reset osmostat, and 24 (38%) with RSW with 21 of these RSW patients presenting without clinical evidence of cerebral disease to warrant changing the nomenclature from cerebral to renal salt wasting. " 02/09/2023 - "The conventional treatment of SIADH includes fluid restriction and salt supplementation. " 02/01/2023 - "Clinical mimics of SIADH like cerebral salt wasting and reset osmostat should be considered in some patients. "
6.	Vasopressin Receptors (Arginine Vasopressin Receptor)IBA 07/01/2016 - "Antagonists for the type 2 vasopressin receptor have demonstrated efficacy in adult patients with SIADH, but evidence in children is lacking. " 08/15/2001 - "In this review, SIADH and other water retaining disorders are briefly discussed, after which the published preclinical and clinical studies in the development of several nonpeptide AVP V2 receptor antagonists are summarized. " 11/01/2013 - "Vaptans, vasopressin V2 receptor antagonists, are new drugs indicated in the treatment of Inappropriate ADH Secretion Syndrome (SIADH). " 10/01/2013 - "Four types of SIADH exist; 10 % of cases represent not SIADH but SIAD (syndrome of inappropriate antidiuresis) due to a constitutive activation of vasopressin receptor that produces water excess. " 05/01/2005 - "BSC1 inhibition complements effects of vasopressin V2 receptor antagonist on hyponatremia in SIADH rats."
7.	Uric Acid (Urate)IBA 01/01/1988 - "In Group C six of the nine had abnormally increased fractional clearance of uric acid (31.6 +/- 3.8) in addition to accepted biochemical criteria of SIADH. " 12/01/2016 - "Based on the previous studies, we hypothesized that V1a receptor may play a principal role in inducing hypouricemia in SIADH and examined uric acid metabolism using a rat model. " 10/01/2000 - "This study examines the effects of a 2-L infusion of isotonic saline over 24 hours on FE of uric acid in 9 normonatremic volunteers and 17 hyponatremic patients with SIADH. " 09/01/2018 - "Uric acid cannot be used to distinguish between SIADH and CSW." 12/01/2016 - "Stimulation of V1a receptor increases renal uric acid clearance via urate transporters: insight into pathogenesis of hypouricemia in SIADH."
8.	mozavaptanIBA 06/11/2013 - "Mozavaptan was effective for improvement of hyponatraemia in this patient with Scc-GB complicated with SIADH." 12/01/1992 - "OPC-31260 is thought to be useful in the treatment of certain disorders, such as the syndrome of inappropriate secretion of ADH (SIADH)." 06/11/2013 - "Mozavaptan was used for SIADH. " 04/01/1997 - "These results indicate that OPC-31260 is an effective therapeutic agent for hyponatremia in patients with SIADH." 07/01/1993 - "Therapeutic efficacy of non-peptide ADH antagonist OPC-31260 in SIADH rats."
9.	Deamino Arginine Vasopressin (Desmopressin)FDA LinkGeneric 01/01/2023 - "On the basis of the study findings in which no patients met the criteria for SIADH or were endocrinologically unstable after postoperative day 6, it is reasonable to suggest that otherwise stable patients can be discharged at or before postoperative day 6 when ADH fluctuations have normalized and endocrinopathy is appropriately managed with oral desmopressin. " 01/01/2008 - "The SIADH rats, but not the dDAVP-excess rats, showed a marked attenuation of urinary concentrating ability. " 01/01/2008 - "We compared the experimental SIADH rats with 1-deamino-8-D-AVP (dDAVP)-excess rats. " 04/01/2004 - "The SIADH rats, but not the dDAVP excess rats, showed a marked attenuation of urinary concentrating ability. " 04/01/2004 - "We compared experimental SIADH with 1-deamino-8-d-arginine vasopressin (dDAVP)-excess rats, where both groups received continuous subcutaneous administration of dDAVP by osmotic minipump but the SIADH rats also received a liquid diet that induced hyponatraemia. "
10.	DiureticsIBA 11/01/2018 - "While fluid restriction, hypertonic saline infusion, diuretics, and the treatment of underlying conditions constitute the first line of treatment of SIADH, in refractory cases, and especially for pediatric patients, there seems not to be any other choice for treatment. " 01/01/2007 - "SIADH is more likely in some populations, including people who are elderly or who take diuretics. " 12/01/2002 - "The current or recent use of diuretics is a possible pitfall in the diagnosis of SIADH. " 08/01/1987 - "Diagnosis of SIADH is confirmed by demonstration of a high urine osmolality with a low plasma osmolality, in the absence of diuretic use. " 01/01/2018 - "We therefore suggest that diuretic induced hyponatremia with an SIADH-like biochemical profile, should be treated mainly by solute -repletion."

Therapies and Procedures

1.	Therapeutics 01/01/2021 - "Further research on the efficacy of therapies for pediatric SIADH is needed, although some adult treatments hold promise for pediatrics. " 02/15/2022 - "The patient completed the FOLFOX therapy without developing SIADH. " 01/01/2019 - "Fluid restriction is the standard therapy in SIADH. " 01/01/2016 - "The various guidelines and recommendations for treatment of hyponatraemia all emphasise that fluid restriction is first line therapy for SIADH, but we feel that it is ineffective or unfeasible in many patients. " 01/01/2016 - "The mechanisms and the evidence base recommendations of the available therapies for SIADH are discussed in this article. "
2.	Drug Therapy (Chemotherapy) 11/01/2005 - "Uniquely in this case, after chemotherapy the paraneoplastic SIADH improved in parallel with a tumour response and this has not been reported previously." 10/01/2015 - "SIADH is an important clinical manifestation that does not occur after all chemotherapy courses. " 01/01/2004 - "Several types of tumour and different chemotherapy drugs can produce this SIADH. " 01/01/2004 - "There was no further recurrence of SIADH after the curative surgery and chemotherapy. " 10/01/2001 - "She developed SIADH 48 hours following chemotherapy. "
3.	Radiotherapy 07/01/2017 - "We present a case of SCCP with SIADH that was successfully treated with radiotherapy in the metastatic lymphnodes and prostate. " 01/01/2012 - "NSCLC-associated SIADH has been reported only thrice over the past two decades and never following radiation therapy with clinical improvement. " 04/01/1987 - "Five of the six patients who developed SIADH had previously undergone a neck dissection and/or had received radiation therapy. " 06/07/2019 - "In this article, we also review the current indications for radiotherapy in various lung cancers and the management of SIADH." 07/01/2017 - "To our knowledge, this is the first case of SCCP with SIADH treated with radiotherapy to improve hyponatremia."
4.	Combination Drug Therapy (Combination Chemotherapy) 08/01/1986 - "SIADH occurred most often with initial presentation (33 of 40), and resolved promptly (less than 3 weeks) with initiation of combination chemotherapy in 80% of evaluable patients. " 01/01/1983 - "However, the initial treatment of choice for SIADH associated with small cell carcinoma of the lung is combination chemotherapy." 01/01/1983 - "Intensive combination chemotherapy produced objective tumor responses in all patients, and syndrome of inappropriate ADH secretion (SIADH) resolved in 16 of 17 evaluable patients within three weeks of initiation of treatment. " 12/01/1998 - "Fluid restriction improved SIADH, and combination chemotherapy for SCLC improved the lactic acidosis although the tumor size did not change." 05/30/2023 - "The patient had a left inoperable mediastinohilar relapse in 2018, which was treated using polychemotherapy The patient also had an occurrence of progressive metastasis and a syndrome of inappropriate antidiuretic hormone secretion (SIADH) in 2019 for which immunotherapy was initiated. "
5.	Medication Reconciliation 11/01/2023 - "Detailed workup and medication reconciliation revealed no other medical conditions or intake of drugs associated with SIADH; however, the patient's low serum osmolality, high urine osmolality, high urine sodium, and improvement in serum sodium level with the initiation of 0.9% saline, salt tablets, and tolvaptan verify the presence of SIADH. "