van der Bilt Floor, Alsma Jelmer
Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Erasmus MC, Rotterdam, The Netherlands.
Intern Med J. 2023 Feb;53(2):285-288. doi: 10.1111/imj.16016.
Hyponatraemia is frequently seen in the emergency department, possibly caused by the syndrome of inappropriate antidiuresis (SIAD). We report three cases in which we believe urinary retention with bladder distention caused hyponatraemia. Laboratory findings fulfilled the criteria for SIAD, for which no cause was found. Possibly pain or sympathetic nerve system activation leads to SIAD. Brisk diuresis occurred after placement of an indwelling urinary catheter with overly correction of sodium for which treatment was necessary. Clinicians should be aware that placement of an indwelling urinary catheter may prompt brisk water diuresis and a tendency to overcorrection.
低钠血症在急诊科很常见，可能由抗利尿激素分泌失调综合征（SIAD）引起。我们报告了三例我们认为膀胱扩张导致尿潴留进而引起低钠血症的病例。实验室检查结果符合SIAD的标准，但未发现病因。可能是疼痛或交感神经系统激活导致了SIAD。留置导尿管后出现大量利尿，钠过度纠正，因此需要进行治疗。临床医生应意识到，留置导尿管可能会引发大量水利尿和过度纠正的倾向。
