Prospective determination of the incidence and severity of hyponatraemia in older hospitalised patients with acute urinary tract obstruction

Shapiro, Dvorah Sara; Alexandrovich, Irina; Sonnenblick, M; Shavit, Linda; Munter, Gabriel; Friedmann, Reuven

doi:10.1093/ageing/afab234

Cited by 3 publications

(1 citation statement)

References 14 publications

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“…The underlying pathophysiological mechanism in this case is not clear, although it is possible that it is similar to other inflammatory processes that stimulate the non-osmotic secretion of ADH. SIAD is also described in the context of acute urinary retention, probably due to stimulation of ADH secretion by bladder distension [3,4]. It is possible that in our case, infiltration of the bladder wall by the inflammatory mass stimulated ADH by a similar mechanism.…”

Section: Discussionmentioning

confidence: 60%

Syndrome of Inappropriate Antidiuresis Due to Chronic Perforated Diverticulitis With Colovesical Fistula

Ropero-Luis¹

2023

Cureus

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A 54-year-old man presented with symptoms of dysuria and cloudy urine, as well as a history of passing stool in urine and repeated urinary tract infections over the past three months. He had previously undergone surgery for diverticulitis with secondary peritonitis 22 years prior. At the time of examination, the patient was in good general condition and euvolemic and had a plasma sodium level of 128 mmol/L and abnormally elevated urinary osmolality. Treatment involved oral urea and drinking according to thirst. After ruling out hypothyroidism and secondary adrenal insufficiency, the patient was diagnosed with syndrome of inappropriate antidiuresis (SIAD). A neoplastic-like mass in the sigmoid colon that infiltrated the bladder floor with a fistulous tract was found. The patient underwent a planned surgical intervention and maintained eunatremia without urea treatment postoperatively. The biopsy showed diverticulosis with intense inflammation in the submucosa but no neoplasia. This is the first reported case of SIAD associated with a colovesical fistula due to chronic perforated diverticulitis.

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Section: Discussionmentioning

confidence: 60%

Syndrome of Inappropriate Antidiuresis Due to Chronic Perforated Diverticulitis With Colovesical Fistula

Ropero-Luis¹

2023

Cureus

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Multiple drugs

2022

Reactions Weekly

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Urinary Retention in Older Adults with Hyponatraemia admitted to Internal Medical and acute Geriatric wards

Shapiro,

Ellis,

Mouhtaseb

et al. 2024

Preprint

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Background Hyponatraemia and urinary retention are common medical problems. Whilst associations between the two are documented, research has not clearly highlighted the prevalence of urinary retention in hyponatraemic patients. Objectives Determining the prevalence of urinary retention in hyponatraemic patients and assessing whether urinary catheter insertion itself affects the correction rate. Methods A prospective, single centre, observational study including patients hospitalised in internal medicine and geriatric wards. A total of 199 patients were investigated: 100 with hyponatraemia ≤129 mEq/L, of these, 70 had severe hyponatraemia ≤125 mEq/L and 99 normonatraemic controls. The incidence of urinary retention was checked in all groups. Hyponatraemic patients underwent complete assessment for the cause of hyponatraemia and sodium levels were followed up for 48 hours. Results: There was a marked increase in the incidence of urinary retention in hyponatremic patients as compared to those with normal sodium levels (41% vs 21% p=0.004). When comparing to those with severe hyponatraemia, a slightly greater difference was found (44% vs 21% p=0.001). When comparing the hyponatraemic patients with and without urinary retention, there was no difference in sodium correction rate between the two groups. Patients with polyuria secondary to post obstructive diuresis had a more rapid sodium correction (9.2±6.8mEq/L vs 5.8±4.8mEq/L (p=0.05)) Conclusions: There is a significantly higher prevalence of urinary retention in patients with hyponatremia which is associated with the severity of hyponatraemia. Post obstructive diuresis following catheter insertion is a predictor of rapid sodium correction. We recommend a routine bladder scan for all patients with hyponatraemia.

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Prospective determination of the incidence and severity of hyponatraemia in older hospitalised patients with acute urinary tract obstruction

Cited by 3 publications

References 14 publications

Syndrome of Inappropriate Antidiuresis Due to Chronic Perforated Diverticulitis With Colovesical Fistula

Syndrome of Inappropriate Antidiuresis Due to Chronic Perforated Diverticulitis With Colovesical Fistula

Multiple drugs

Urinary Retention in Older Adults with Hyponatraemia admitted to Internal Medical and acute Geriatric wards

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