Indirect evidence to suggest that hyponatremia by itself cotributes to the high urate clearance in the SIADH
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:102A 1997
The high urate clearance in SIADH has been attributed to volume expansion. Indeed, some patients with SIADH have lower than normal plasma protein concentrations (a marker of volume expansion). In order to simulate the approximately 10% increase in plasma volume seen in SIADH, the authors infused 2L of isotonic saline over 24h in 10 healthy subjects age- and sex-matched to 11 SIADH patients. Saline infusion lowered plasma protein concentration to a level equivalent to that seen in SIADH. Fractional excretion of urate increased from 7 to 9% but was still much less than the 16% observed in SIADH. Urate clearance was also increased in 6 additional patients with chronic SIADH and normal plasma protein concentrations. Since sodium concentration can alter urate reabsorption in brush-border membrane vesicles, the authors suggest that hyponatremia per se contributes to the high urate clearance in SIADH.
Comment: These are provocative results. They should be confirmed in studies in which plasma volume is directly measured. (David J. Leehey, M.D., Loyola University at Chicago)
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ASN 30th Annual Meeting, San Antonio
Sodium/water transport : Hyponatremia