Evaluation of copeptin and commonly used laboratory parameters for the differential diagnosis of profound hyponatraemia in hospitalized patients: ‘The Co-MED Study'

Nigro, N; Winzeler, Bettina; Suter‐Widmer, Isabelle; Schuetz, Philipp; Arici, Birsen; Bally, Martina; Blum, C; Nickel, Christian H.; Bingisser, Roland; Böck, Andreas; Huber, Andreas; Müller, Beat; Christ‐Crain, Mirjam

doi:10.1111/cen.13243

Cited by 59 publications

(57 citation statements)

References 34 publications

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“…20 Of a total of 298 patients with profound hyponatraemia, we enclosed all patients in whom hyponatraemia was predominant due to PP (N=23). 20 Of a total of 298 patients with profound hyponatraemia, we enclosed all patients in whom hyponatraemia was predominant due to PP (N=23).…”

Section: Methodsmentioning

confidence: 99%

“…Smoking amount (py), median (IQR) 40 (20-60) 20 (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) 20 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) 59 (49-60) <.001…”

Section: Factors Contributing To the Development Of Hyponatraemiaunclassified

“…propriate antidiuretic hormone secretion) 20. We hypothesize that for patients with PP to become hyponatraemic, a certain AVP stimulus is needed.…”

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confidence: 99%

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Characteristics and outcomes of patients with profound hyponatraemia due to primary polydipsia

Sailer

Winzeler

Nigro

et al. 2017

Clinical Endocrinology

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Section: Methodsmentioning

confidence: 99%

Section: Factors Contributing To the Development Of Hyponatraemiaunclassified

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Characteristics and outcomes of patients with profound hyponatraemia due to primary polydipsia

Sailer

Winzeler

Nigro

et al. 2017

Clinical Endocrinology

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“…Recent studies have focused on the use of a novel parameter, co-peptin, as a surrogate marker for vasopressin and its potential role as a diagnostic parameter in the differential diagnosis of hyponatraemia has been discussed. 45 However, as AVP is elevated in almost all causes of hyponatraemia co-peptin is unlikely to be of significant clinical utility at present. In patients with primary polydipsia, a low co-peptin may be a useful diagnostic tool.…”

Section: Diagnosis and Investigationsmentioning

confidence: 99%

Hyponatraemia – presentations and management

2017

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Hyponatraemia is the most common electrolyte disturbance encountered in clinical practice. It is associated with signifi cant morbidity and mortality, thus appropriate investigation and treatment is essential. Hyponatraemia presents with a spectrum of clinical presentations ranging from no symptoms to life-threatening neurological sequelae. Hyponatraemia has multiple aetiologies and distinguishing the underlying aetiology facilitates appropriate treatment. This review provides an overview of the presentations and approaches to management of this common clinical condition. IntroductionHyponatraemia (defined as serum sodium <135 mmol/L) is the most common electrolyte abnormality and is encountered in all areas of clinical practice.1 Hyponatraemia is associated with increased morbidity and mortality.2 The assessment of patients with hyponatraemia can pose a clinical challenge and strategies for its management are often suboptimal. In recent years, expert guidance and recommendations have been published that provide an evidence-based approach to diagnosis and treatment of hyponatraemia 3,4 although it should be highlighted that highquality evidence is lacking for many aspects of hyponatraemia management. Additionally, new therapies have emerged promising a more targeted approach to regulating body water and sodium balance in certain patients with hyponatraemia. EpidemiologyHyponatraemia occurs in approximately 15-30% of hospitalised patients, with 1-2% of patients having a serum sodium level <125 mmol/L. 5,6 In addition, hyponatraemia is often underreported in the hospital setting. 7 In the intensive care unit, approximately 25-30% of patients will have a serum sodium <134 mmol/L. 8,9 In neurosurgical units, hyponatraemia is reported in up to 50% of patients with subarachnoid haemorrhage in retrospective 2 and prospective studies.10 Hyponatraemia is also a common occurrence in ABSTRACT Hyponatraemia -presentations and management heart failure with an incidence of approximately 20% in patients hospitalised for heart failure. 11 Age-related changes and chronic diseases are often associated with abnormalities in water homeostasis. Miller et al 12 have reported that more than 50% of nursing home residents had at least one episode of hyponatraemia over a 12-month study period. Morbidity and mortality associated with hyponatraemiaHyponatraemia is associated with increased morbidity and mortality. Acute severe symptomatic hyponatraemia is a medical emergency that carries a high mortality rate if not addressed acutely. A recent prospective observational study found a positive correlation of serum sodium and mortality, with a serum sodium <125 mmol/L associated with a substantial 1-year mortality, recurrence of hyponatraemia and rehospitalisation rate.13 'Asymptomatic' chronic mild hyponatraemia has previously been thought to be clinically insignificant; however, recent evidence shows that mild chronic 'asymptomatic' hyponatraemia, particularly in an older population, may contribute to impaired cognition, 14 increased risk o...

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“…In addition, how discriminatory is copeptin if vasopressin is elevated in the majority of patients with hyponatraemia? Nigro et al .. show that plasma copeptin tended to be higher in hypovolaemic or hypervolaemic hyponatraemia compared with SIAD . This phenomenon is known as ‘osmoreceptor gain’, in which high plasma angiotensin II levels potentiate volume‐mediated vasopressin release .…”

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Differential diagnosis of hyponatraemia: moving forward?

Hoorn

2016

Clin Endocrinol

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Evaluation of copeptin and commonly used laboratory parameters for the differential diagnosis of profound hyponatraemia in hospitalized patients: ‘The Co-MED Study'

Cited by 59 publications

References 34 publications

Characteristics and outcomes of patients with profound hyponatraemia due to primary polydipsia

Characteristics and outcomes of patients with profound hyponatraemia due to primary polydipsia

Hyponatraemia – presentations and management

Differential diagnosis of hyponatraemia: moving forward?

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