Sonnenblick M, Rosin A
Department of Geriatrics, Shaare Zedek Medical Center, Jerusalem, Israel.
Isr J Med Sci. 1988 Jan;24(1):20-3.
Twenty-eight elderly inpatients with severe hyponatremia were investigated prospectively to determine if fractional uric acid clearance was increased significantly in the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) compared with other causes of hyponatremia. The patients were divided into three groups: Group A--hyponatremia due to SIADH, Group B--hyponatremia due to diuretic use, and Group C--hyponatremia possibly due to a number of causes. Serum uric acid was 3.2 +/- 0.4 and 5.3 +/- 0.6 in Groups A and B, respectively (P less than 0.05). Fractional clearance of urate in Groups A and B were 43 +/- 5.1 and 16.7 +/- 1.9, respectively (P less than 0.001). In Group C six of the nine had abnormally increased fractional clearance of uric acid (31.6 +/- 3.8) in addition to accepted biochemical criteria of SIADH. In 10 patients with SIADH, urate clearance measured before water restriction was 40.2 +/- 9.0%, and after serum sodium returned to normal 11.6 +/- 1.5 (P = 0.05). Of the total 28 patients 17 had increased fractional uric acid clearance with biochemical criteria of SIADH, suggesting that this syndrome is a common cause of the increased susceptibility to hyponatremia among older patients.
对28例老年重度低钠血症住院患者进行前瞻性研究，以确定抗利尿激素分泌不当综合征（SIADH）患者与其他原因所致低钠血症患者相比，尿酸清除分数是否显著增加。患者分为三组：A组——SIADH所致低钠血症；B组——利尿剂使用所致低钠血症；C组——可能由多种原因所致低钠血症。A组和B组的血清尿酸分别为3.2±0.4和5.3±0.6（P<0.05）。A组和B组的尿酸清除分数分别为43±5.1和16.7±1.9（P<0.001）。C组9例中有6例除符合SIADH公认的生化标准外，尿酸清除分数异常增加（31.6±3.8）。在10例SIADH患者中，限水前尿酸清除率为40.2±9.0%，血钠恢复正常后为11.6±1.5（P=0.05）。28例患者中，17例符合SIADH生化标准且尿酸清除分数增加，提示该综合征是老年患者易发生低钠血症的常见原因。
