Early water intake restriction to prevent inappropriate antidiuretic hormone secretion following transsphenoidal surgery: low BMI predicts postoperative SIADH
Matsuyama J, Ikeda H, Sato S, Yamamoto K, Ohashi G, Watanabe K
European journal of endocrinology · 30 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Cohort study (classified by our AI screen)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
Who paid for it
- Funding
- Funding not disclosed
Publication
- Published
- 2014-09-17 · Eur J Endocrinol · vol. 171 · issue 6 · pp. 711–716
- Publisher
- Oxford University Press
- Cited
- 44 citations · more than 69% of similar papers · 0.6× the field average
- References
- 7 works
- Access
- Paywalled
- Research areas
- Pituitary Gland Disorders and Treatments · Electrolyte and hormonal disorders · Nutrition and Health in Aging
- Keywords
- Medicine, Incidence (geometry), Syndrome of inappropriate antidiuretic hormone secretion, Urine osmolality, Antidiuretic, Fluid restriction, Hyponatremia, Internal medicine, Transsphenoidal surgery, Urine, Retrospective cohort study, Vasopressin, Surgery, Pituitary adenoma, Adenoma
- MeSH
- sphenoid bone, humans, adenoma, pituitary neoplasms, inappropriate adh syndrome, postoperative complications, body mass index, prognosis, postoperative care, neurosurgical procedures, water deprivation, drinking, time factors, adolescent, adult, aged, aged, 80 and over, middle aged, child, female, male, young adult
6 authors
From JP
- Junko Matsuyama · correspondingSouthern Tohoku General Hospital
- Hidetoshi IkedaSouthern Tohoku General Hospital
- Shunsuke SatoSouthern Tohoku General Hospital
- Koh YamamotoSouthern Tohoku General Hospital
- Genichiro OhashiSouthern Tohoku General Hospital
- Kazuo WatanabeSouthern Tohoku General Hospital
Abstract
Objective
The goals of this study were to assess the incidence of and risk factors for the syndrome of inappropriate antidiuretic hormone secretion (SIADH) in patients following transsphenoidal surgery (TSS), and to validate the effectiveness of early prophylactic restriction of water intake.
Design
Retrospective analysis was performed for 207 patients who had undergone TSS, including 156 patients not placed on early prophylactic water restriction. Sixty-four patients received treatment for SIADH.
Methods
We compared the incidence of SIADH between patients with and without early water intake restriction, and analyzed various risk factors for SIADH using statistical analyses.
Results
BMI was significantly lower for patients with SIADH than for those patients without SIADH. Statistical analysis revealed that the threshold BMI predicting SIADH was 26. Serum sodium levels on postoperative days 5-10 and daily urine volumes on postoperative days 5-10 were significantly lower in patients with SIADH than in those without SIADH. Postoperative body weight loss on days 6, 8, 10, and 11 was significantly higher in patients with SIADH. The incidence of SIADH after starting prophylactic water intake restriction (14%) was significantly lower than the rate before early water restriction (38%; P<0.05).
Conclusions
SIADH is relatively common after TSS, and serum sodium concentrations and daily urine volumes should be carefully monitored. Patients with low preoperative BMI should be closely observed, as this represented a significant preoperative risk factor for SIADH. Early prophylactic water intake restriction appears effective at preventing postoperative SIADH.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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