Diagnosing and Treating the Syndrome of Inappropriate Antidiuretic Hormone Secretion Joseph G. Verbalis, MD, Arthur Greenberg, MD, Volker Burst, MD, Jean-Philippe.

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Presentation transcript:

Diagnosing and Treating the Syndrome of Inappropriate Antidiuretic Hormone Secretion Joseph G. Verbalis, MD, Arthur Greenberg, MD, Volker Burst, MD, Jean-Philippe Haymann, MD, Gudmundur Johannsson, MD, PhD, Alessandro Peri, MD, PhD, Esteban Poch, MD, Joseph A. Chiodo, PharmD, Jiten Dave, MD The American Journal of Medicine Volume 129, Issue 5, Pages 537.e9-537.e23 (May 2016) DOI: 10.1016/j.amjmed.2015.11.005 Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 1 Outcomes and use of second therapies in patients with baseline serum sodium concentrations <130 mEq/L treated with fluid restriction or isotonic saline as monotherapy. (A) Patients with laboratory-diagnosed syndrome of inappropriate antidiuretic hormone secretion initially treated with fluid restriction as monotherapy. (B) Patients with laboratory-diagnosed syndrome of inappropriate antidiuretic hormone secretion initially treated with isotonic saline as monotherapy. The decision to initiate a second treatment or not and the selection of any such treatments were made by the patients' treating physicians without input from the investigators. All serum [Na+] values are mean ± standard deviation in mEq/L. FR = fluid restriction; HS = hypertonic saline; [Na+] = serum sodium concentration; NS = isotonic saline; SIADH = syndrome of inappropriate antidiuretic hormone secretion; TO = tolvaptan. aPretreatment value. bSuccess defined as proportion of patients with [Na+] increase in [Na+] ≥5 mEq/L. The American Journal of Medicine 2016 129, 537.e9-537.e23DOI: (10.1016/j.amjmed.2015.11.005) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 2 Median length of hospital stay for all patients with syndrome of inappropriate antidiuretic hormone secretion and the US and EU cohorts separately. P <.05: EU-FR vs tolvaptan; HS vs tolvaptan. FR = fluid restriction; HS = hypertonic saline; LOS = length of stay; NS = isotonic saline; TO = tolvaptan. The American Journal of Medicine 2016 129, 537.e9-537.e23DOI: (10.1016/j.amjmed.2015.11.005) Copyright © 2016 Elsevier Inc. Terms and Conditions