• Critical care clinics · Apr 2019

    Review

    Diabetes Insipidus and Syndrome of Inappropriate Antidiuretic Hormone in Critically Ill Patients.

    • Anatole Harrois and James R Anstey.
    • Intensive Care Unit, Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria 3050, Australia; Department of Anesthesiology and Surgical Intensive Care, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Sud, Université Paris Saclay, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France. Electronic address: harroisanatole@yahoo.fr.
    • Crit Care Clin. 2019 Apr 1; 35 (2): 187-200.

    AbstractDiabetes insipidus and the syndrome of inappropriate antidiuretic hormone secretion lie at opposite ends of the spectrum of disordered renal handling of water. Whereas renal retention of water insidiously causes hypotonic hyponatremia in syndrome of inappropriate antidiuretic hormone secretion, diabetes insipidus may lead to free water loss, hypernatremia, and volume depletion. Hypernatremia and hyponatremia are associated with worse outcomes and longer intensive care stays. Moreover, pathologies causing polyuria and hyponatremia in patients in intensive care may be multiple, making diagnosis challenging. We provide an approach to the diagnosis and management of these conditions in intensive care patients.Copyright © 2018 Elsevier Inc. All rights reserved.

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