Nutricion hospitalaria最新文献_第6页

[Hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion - When clinical cases teach us]. 【抗利尿激素分泌不当引起的低钠血症综合征——当临床病例教给我们】。

IF 1.3 4区医学

Nutricion hospitalaria Pub Date : 2026-09-02 DOI: 10.20960/nh.07096

Jorge Gabriel Ruiz-Sánchez

引用次数: 0

[From syndrome of inappropriate antidiuretic hormone secretion deficiency to excess - Challenges and solutions in a unique case]. 【从抗利尿激素分泌不足到分泌过量综合征——个例的挑战与解决方法】。

IF 1.3 4区医学

Nutricion hospitalaria Pub Date : 2026-09-02 DOI: 10.20960/nh.07098

Patricia Tomás Gómez, Francisco Lupión Lorente, Manuel Blanca Padilla, Marta Núñez Jijménez-Bravo

{"title":"[From syndrome of inappropriate antidiuretic hormone secretion deficiency to excess - Challenges and solutions in a unique case].","authors":"Patricia Tomás Gómez, Francisco Lupión Lorente, Manuel Blanca Padilla, Marta Núñez Jijménez-Bravo","doi":"10.20960/nh.07098","DOIUrl":"10.20960/nh.07098","url":null,"abstract":"Introduction: Introduction: the sequential transition from central diabetes insipidus (CDI) to the syndrome of inappropriate antidiuretic hormone secretion (SIADH) is an exceptionally rare condition and represents a major diagnostic and therapeutic challenge. Case report: we report the case of a 47-year-old man with Burkitt lymphoma involving the hypothalamic-pituitary region who initially presented with polyuria, polydipsia, and hypernatremia. CDI was confirmed by biochemical findings and a positive response to desmopressin. Following desmopressin treatment and intensive chemotherapy, rapid tumor regression and partial recovery of neurohypophyseal function were observed. During follow-up, the patient developed persistent euvolemic hyponatremia with low plasma osmolality, inappropriately concentrated urine, and elevated urinary sodium. After excluding adrenal insufficiency, hypothyroidism, desmopressin overtreatment, and other secondary causes, SIADH was diagnose. Discussion: this case highlights the rare sequential transition from ADH deficiency to ADH excess caused by the same hypothalamic-pituitary disease and supports oral urea as an effective, safe, and cost-effective therapeutic option for chronic SIADH.","PeriodicalId":19385,"journal":{"name":"Nutricion hospitalaria","volume":" ","pages":"6-10"},"PeriodicalIF":1.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[When growth hormone levels drop - Management with urea of postoperative inappropriate antidiuretic hormone secretion syndrome in a patient who underwent surgery for acromegaly]. [当生长激素水平下降-尿素治疗肢端肥大症患者术后抗利尿激素分泌不当综合征]。

IF 1.3 4区医学

Nutricion hospitalaria Pub Date : 2026-09-02 DOI: 10.20960/nh.07101

Cristina Guillén, Ada María Roldán Sánchez, María Eugenia Torregrosa-Quesada, Javier Abarca, Elena García Garrigós, Antonio Picó Alfonso

{"title":"[When growth hormone levels drop - Management with urea of postoperative inappropriate antidiuretic hormone secretion syndrome in a patient who underwent surgery for acromegaly].","authors":"Cristina Guillén, Ada María Roldán Sánchez, María Eugenia Torregrosa-Quesada, Javier Abarca, Elena García Garrigós, Antonio Picó Alfonso","doi":"10.20960/nh.07101","DOIUrl":"10.20960/nh.07101","url":null,"abstract":"Introduction: Introduction: postoperative hyponatremia is a common complication after endoscopic transsphenoidal surgery, with an incidence of 9-35 % that rises to 41.5 % in patients with acromegaly. Case report: a 74-year-old woman diagnosed with acromegaly underwent endoscopic transsphenoidal surgery and developed severe symptomatic hyponatremia (sodium 117 mmol/l) due to SIADH on postoperative day 11, after other causes of postoperative hyponatremia were ruled out. Following initial correction with hypertonic saline, treatment with oral urea (15 g/day) was started, achieving a safe increase in serum sodium (133 mmol/l at 48 hours) that allowed hospital discharge. One week later, with normalized sodium levels (137 mmol/l), treatment was withdrawn without subsequent recurrence. Discussion: oral urea is an effective, well-tolerated and cost-effective first-line treatment for SIADH after pituitary surgery, particularly relevant in patients with acromegaly given their higher incidence of late hyponatremia. Systematic sodium monitoring during the highest-risk period could allow earlier treatment initiation and prevent progression to severe cases.","PeriodicalId":19385,"journal":{"name":"Nutricion hospitalaria","volume":" ","pages":"20-23"},"PeriodicalIF":1.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Oral urea in paraneoplastic syndrome of inadequate antidiuretic hormone secretion due to small-cell carcinoma ‒ Sustained, safe, and cost-effective correction through outpatient management]. 口服尿素治疗小细胞癌所致抗利尿激素分泌不足的副肿瘤综合征——通过门诊管理进行持续、安全、经济的纠正。

IF 1.3 4区医学

Nutricion hospitalaria Pub Date : 2026-09-02 DOI: 10.20960/nh.07106

Manuel Carpio Salmerón, Georgios Kyriakos

{"title":"[Oral urea in paraneoplastic syndrome of inadequate antidiuretic hormone secretion due to small-cell carcinoma ‒ Sustained, safe, and cost-effective correction through outpatient management].","authors":"Manuel Carpio Salmerón, Georgios Kyriakos","doi":"10.20960/nh.07106","DOIUrl":"10.20960/nh.07106","url":null,"abstract":"Introduction: Introduction: syndrome of inappropriate antidiuretic hormone secretion (SIADH) is an important cause of euvolemic hyponatremia and may represent the first clinical manifestation of an underlying malignancy, particularly small cell lung carcinoma. Case report: we report the case of a 71-year-old active smoker who presented to the emergency department with a three-week history of encephalopathy, including disorientation, psychomotor slowing, reduced appetite, occasional night sweats, and weight loss. Initial evaluation revealed severe symptomatic hyponatremia, requiring treatment with 3 % hypertonic saline and close monitoring. Subsequent assessment fulfilled the diagnostic criteria for SIADH. A targeted etiological work-up, including imaging studies and biopsy, confirmed the presence of pulmonary small cell carcinoma. After acute management of hyponatremia, and given its persistence, oral urea was initiated, first at a dose of 15 g/day and subsequently increased to 30 g/day, achieving progressive and sustained normalization of serum sodium levels. Discussion: this case highlights the importance of considering paraneoplastic SIADH in patients with severe euvolemic hyponatremia and supports oral urea as an effective, safe, cost-effective, and practical therapeutic option for both inpatient and outpatient management of SIADH secondary to small cell lung carcinoma.","PeriodicalId":19385,"journal":{"name":"Nutricion hospitalaria","volume":" ","pages":"35-39"},"PeriodicalIF":1.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion in a childhood cancer survivor ‒ The role of oral urea in treatment]. [儿童癌症幸存者抗利尿激素分泌不当引起的低钠血症-口服尿素在治疗中的作用]。

IF 1.3 4区医学

Nutricion hospitalaria Pub Date : 2026-09-02 DOI: 10.20960/nh.07109

Carla Jimena Santiváñez Pérez

{"title":"[Hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion in a childhood cancer survivor ‒ The role of oral urea in treatment].","authors":"Carla Jimena Santiváñez Pérez","doi":"10.20960/nh.07109","DOIUrl":"10.20960/nh.07109","url":null,"abstract":"Introduction: Introduction: syndrome of inappropriate antidiuretic hormone secretion (SIADH) is one of the most common causes of euvolemic hyponatremia and is especially relevant in patients with central nervous system disorders. Case report: we present the case of a 37-year-old man with a history of cerebellar medulloblastoma treated in childhood with surgery, radiotherapy, and chemotherapy, who developed long-term endocrine sequelae and intracranial tumor recurrence in adulthood, and was admitted with symptomatic hyponatremia secondary to chronic SIADH. Evaluation showed hypoosmolar hyponatremia, elevated urinary sodium, and inappropriately high urine osmolality, after excluding adrenal insufficiency by ACTH stimulation testing and confirming adequate control of central hypothyroidism. Given the recurrence of the condition and the limited suitability of vaptans, oral urea was indicated as maintenance treatment, initially at 7.5 g/day and later at 15 g every 12 hours, achieving stabilization of serum sodium levels and good clinical tolerance. Discussion: this case highlights the diagnostic and therapeutic complexity of SIADH in neuro-oncological patients with associated endocrinopathies and supports the role of oral urea as an effective and safe therapeutic alternative.","PeriodicalId":19385,"journal":{"name":"Nutricion hospitalaria","volume":" ","pages":"48-52"},"PeriodicalIF":1.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[The effectiveness of urea in the management of chronic hyponatremia and its impact on nutritional status]. [尿素治疗慢性低钠血症的有效性及其对营养状况的影响]。

IF 1.3 4区医学

Nutricion hospitalaria Pub Date : 2026-09-02 DOI: 10.20960/nh.07107

Lucía Estévez Asensio, Paloma Pérez López, M ª Del Puerto Bernoy González, Mario Alfredo Vásquez-Saavedra, Beatriz Ramos Bachiller, Daniel de Luis, Emilia Gómez Hoyos

引用次数: 0

[Oral urea in the management of inappropriate antidiuretic hormone secretion syndrome associated with Guillain-Barré syndrome, severe dysautonomia, and pheochromocytoma ‒ An exceptional clinical case]. [口服尿素治疗吉兰-巴罗综合征、严重自主神经异常和嗜铬细胞瘤相关的抗利尿激素分泌不当综合征-一个例外的临床病例]。

IF 1.3 4区医学

Nutricion hospitalaria Pub Date : 2026-09-02 DOI: 10.20960/nh.07111

Everardo J Díaz-López, María Fernández Angüeso

{"title":"[Oral urea in the management of inappropriate antidiuretic hormone secretion syndrome associated with Guillain-Barré syndrome, severe dysautonomia, and pheochromocytoma ‒ An exceptional clinical case].","authors":"Everardo J Díaz-López, María Fernández Angüeso","doi":"10.20960/nh.07111","DOIUrl":"10.20960/nh.07111","url":null,"abstract":"Introduction: Introduction and case report: we report the case of an 82-year-old man with pheochromocytoma and colon adenocarcinoma who developed rapidly progressive Guillain-Barré syndrome with severe dysautonomia following a recent SARS-CoV-2 infection. In this setting, he developed progressive hyponatremia secondary to syndrome of inappropriate antidiuretic hormone secretion (SIADH). Marked autonomic instability related to the coexistence of Guillain-Barré syndrome and pheochromocytoma limited conventional therapeutic options. After an inadequate response to fluid restriction and oral sodium chloride supplementation, oral urea therapy was initiated, resulting in a gradual and safe correction of serum sodium without significant adverse events. Normalization of serum sodium enabled completion of preoperative management and successful adrenalectomy and colon cancer surgery, without recurrence of hyponatremia. Discussion: to our knowledge, this is the first reported case describing the successful use of oral urea for SIADH in a patient with concomitant Guillain-Barré syndrome, severe dysautonomia, and pheochromocytoma, supporting its role as an effective and safe therapeutic option when conventional treatments are limited or ineffective.","PeriodicalId":19385,"journal":{"name":"Nutricion hospitalaria","volume":" ","pages":"56-59"},"PeriodicalIF":1.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Oral urea as a safety strategy in complex syndrome of inappropriate antidiuretic hormone secretion - Challenges posed by polypharmacy and institutionalization]. [口服尿素作为抗利尿激素分泌不当复杂综合征的安全策略-多药和制度化带来的挑战]。

IF 1.3 4区医学

Nutricion hospitalaria Pub Date : 2026-09-02 DOI: 10.20960/nh.07103

Carme Figueredo, Ane Azketa, Aida Orois Añón, Judith Solé Sancho, Mercè Placeres, Adriana Pané

{"title":"[Oral urea as a safety strategy in complex syndrome of inappropriate antidiuretic hormone secretion - Challenges posed by polypharmacy and institutionalization].","authors":"Carme Figueredo, Ane Azketa, Aida Orois Añón, Judith Solé Sancho, Mercè Placeres, Adriana Pané","doi":"10.20960/nh.07103","DOIUrl":"10.20960/nh.07103","url":null,"abstract":"Introduction: Introduction: syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a common cause of euvolemic hyponatremia in older adults. Case report: we report the case of a 72-year-old woman with chronic SIADH, probably secondary to sertraline, in the setting of polyp harmacy and chronic liver disease. Initially, serum sodium normalized with fluid restriction guided by the Furst formula under caregiver supervision. Following the death of her primary caregiver and admission to a long-term care facility, an increase in sertraline dosage and the inability to maintain fluid restriction led to recurrent hyponatremia (serum sodium 126 mEq/l). Tolvaptan was avoided because of the risk of interaction with diltiazem (CYP3A4 inhibitor) and underlying liver disease. Oral urea was initiated and titrated to 30 g/day, achieving gradual and sustained normalization of serum sodium (134-135 mEq/l) without adverse effects or changes to her psychotropic treatment. Six months later, the patient remains clinically stable on 15 g/day of oral urea with progressive sertraline dose reduction. Discussion: this case highlights oral urea as a safe, effective, and cost-effective therapeutic option for SIADH when fluid restriction is not feasible and vaptans are unsuitable, particularly in frail older adults with polypharmacy and complex social circumstances.","PeriodicalId":19385,"journal":{"name":"Nutricion hospitalaria","volume":" ","pages":"28-30"},"PeriodicalIF":1.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[An unusual presentation of syndrome of inappropriate antidiuretic hormone secretion - When things aren't what they seem]. [一种不寻常的抗利尿激素分泌不当综合症的表现-当事情不是他们看起来的那样]。

IF 1.3 4区医学

Nutricion hospitalaria Pub Date : 2026-09-02 DOI: 10.20960/nh.07100

Ignacio Jiménez Hernando, Mónica Gómez-Gordo Hernanz, Marta Pérez Noguero, Blanca Farache Suberviola

{"title":"[An unusual presentation of syndrome of inappropriate antidiuretic hormone secretion - When things aren't what they seem].","authors":"Ignacio Jiménez Hernando, Mónica Gómez-Gordo Hernanz, Marta Pérez Noguero, Blanca Farache Suberviola","doi":"10.20960/nh.07100","DOIUrl":"10.20960/nh.07100","url":null,"abstract":"Introduction: Introduction: hyponatremia is one of the most common electrolyte disorders in clinical practice and requires accurate diagnosis to prevent potentially severe neurological complications. Case report: we report the case of an 18-year-old male with no significant medical history who presented with severe headache, nausea, vomiting, and mild neurological symptoms, and was found to have severe hyponatremia secondary to syndrome of inappropriate antidiuretic hormone secretion (SIADH). After an extensive diagnostic workup with initially negative results, treatment with hypertonic saline was initiated, followed by fluid restriction and oral urea because of the risk of overcorrection. Clinical evolution was favourable, with progressive normalization of serum sodium levels. After discharge, the patient admitted chronic MDMA (3,4-methylenedioxymethamphetamine) use, and discontinuation of the drug allowed withdrawal of treatment without recurrence, confirming MDMA-induced SIADH. Discussion: this case highlights the importance of a thorough medical history and emphasizes the usefulness of oral urea as an effective and safe therapeutic option in patients at high risk of overcorrection.","PeriodicalId":19385,"journal":{"name":"Nutricion hospitalaria","volume":" ","pages":"15-19"},"PeriodicalIF":1.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Under the sword of Damocles - Resolving a complex case of hyponatremia with oral urea in clinical practice]. 【达摩克利斯之剑下——临床应用口服尿素治疗一例复杂的低钠血症】。

IF 1.3 4区医学

Nutricion hospitalaria Pub Date : 2026-09-02 DOI: 10.20960/nh.07097

Ignacio González-Maroto, Belén Fernández de Bobadilla-Pascual, José de Toro-Ruiz, Laura Morales-Bruque, Rocío Iniesta-Pacheco, Eva Cuarteros-Adrián, Álvaro García-Manzanares Vázquez-de Agredos

{"title":"[Under the sword of Damocles - Resolving a complex case of hyponatremia with oral urea in clinical practice].","authors":"Ignacio González-Maroto, Belén Fernández de Bobadilla-Pascual, José de Toro-Ruiz, Laura Morales-Bruque, Rocío Iniesta-Pacheco, Eva Cuarteros-Adrián, Álvaro García-Manzanares Vázquez-de Agredos","doi":"10.20960/nh.07097","DOIUrl":"10.20960/nh.07097","url":null,"abstract":"Introduction: Introduction: hyponatraemia is the most common fluid and electrolyte disorder in clinical practice, occurring in 15-30 % of hospitalised patients, and is associated with increased morbidity, mortality and healthcare costs. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is its most common cause in the hospital setting. Case report: we present the case of a 62-year-old woman admitted for impaired consciousness secondary to severe symptomatic hypoosmolar hyponatraemia (Na+ 105.3 mmol/l). During her hospital stay, she suffered multiple complications related to her clinical condition and pre-existing comorbidities. Subsequently, following stabilisation, persistent SIADH was observed, and treatment with oral urea was initiated. The patient's prognosis was favourable, with progressive normalisation and maintenance of serum sodium concentration. Discussion: this case highlights the importance of aetiological diagnosis and the role of oral urea as an effective and safe treatment, as well as its usefulness in preventing further recurrences in patients with SIADH.","PeriodicalId":19385,"journal":{"name":"Nutricion hospitalaria","volume":" ","pages":"3-5"},"PeriodicalIF":1.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0