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Home > Syndrome of inappropriate antidiuretic hormone


The syndrome of inappropriate antidiuretic hormone (SIADH) is a condition commonly found in the hospital population, especially in patients being hospitalized for central nervous system (CNS) injury. As the name states, this is a syndrome characterized by excessive release of antidiuretic hormone (ADH or vasopression) from the posterior pituitary gland.

The normal function of ADH is to control the concentration of solutes--particularly sodium--in the blood. ADH acts in the distal portion of the renal tubule and causes the retention of water, but not solute. Hence, ADH activity promotes the dilution of sodium in the blood. It furthermore activates the brain's thirst mechanism, causing the individual to drink.

Through an unknown mechanism, CNS injury can cause the plasma ADH level to increase such that water is inappropriately retained by the kidneys. This retention leads to a dilutional hyponatremia and all the consequences associated with that condition: cerebral edema, increased intracranial pressure, hypertension, hyper-reflexia, and renal failure. Though commonly associated with CNS injury, SIADH can also result from an ADH-secreting tumor (usually small cell carcinoma of the lung ).

Treatment of SIADH includes fluid restriction and administration of isotonic saline.



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