Prevalence of adrenal insufficiency among patients with euvolemic hyponatremia

Background The diagnosis of syndrome of inappropriate anti-diuresis requires the exclusion of secondary adrenal insufficiency (AI) among patients with euvolemic hyponatremia (EuVHNa). Studies have suggested that about 2.7–3.8% of unselected patients presenting to the emergency room with EuVHNa have...

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Bibliographic Details
Published in:Endocrine Connections 2021-12, Vol.10 (12), p.1623-1631
Main Authors: Kumar, Amit, Ghosh, Maria, Jacob, Jubbin Jagan
Format: Article
Language:English
Subjects:
adrenal insufficiency
euvolemic hyponatremia
hyponatremia
hypopituitarism
secondary adrenal insufficiency
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Summary:Background The diagnosis of syndrome of inappropriate anti-diuresis requires the exclusion of secondary adrenal insufficiency (AI) among patients with euvolemic hyponatremia (EuVHNa). Studies have suggested that about 2.7–3.8% of unselected patients presenting to the emergency room with EuVHNa have undiagnosed AI and it is as high as 15% among patients admitted to specialized units for evaluation of hyponatremia. Objective To study the prevalence of AI among in-patients with EuVHNa in a general medical ward setting. Methods This was a prospective, single-center observational study conducted among general medical in-patients with EuVHNa, defined as patients with a serum sodium 30 mmol/L. Additionally, patients with recent vomiting, current renal failure, diuretic use and those with uncontrolled hyperglycemia were excluded. Adrenal functions were assessed by a modified adrenocorticotropic hormone (ACTH) stimulation test called the Acton Prolongatum™ stimulation test (APST). A cut-off cortisol value of
ISSN:2049-3614
2049-3614
DOI:10.1530/EC-21-0500