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Normovolaemic, normal Na, slightly increased water

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Causes of normovolaemic hyponatraemia include:

  • SIADH
    • tumours
      • chest/mediastinum e.g. mesothelioma, thymoma,bronchogenic carcinoma
      • nonchest e.g. duodenal carcinoma, pancreatic carcinoma, nasopharyngeal carcinoma, ureteral/prostate carcinoma, uterine carcinoma,leukaemia
    • CNS disorders
      • mass lesions (tumours, abscesses, subdural hematoma)
      • inflammatory diseases (encephalitis, meningitis, multiple sclerosis, systemic lupus, acute intermittent porphyria,)
      • degenerative/demyelinative diseases (Guillain-Barré syndrome; spinal cord lesions)
      • miscellaneous (head trauma, subarachnoid hemorrhage, acute psychosis, delirium tremens, pituitary stalk section, transphenoidal adenomectomy, hydrocephalus)
    • drug induced
      • stimulated AVP release (nicotine, phenothiazines, tricyclics)
      • direct renal effects and/or potentiation of AVP antidiuretic effects (DDAVP, oxytocin, prostaglandin synthesis inhibitors)
      • mixed or uncertain actions (e.g. ACE inhibitors, chlorpropamide, clofibrate, carbamazepine, clozapine, cyclophosphamide, 3,4-methylenedioxymethamphetamine ['Ecstasy'], omeprazole, serotonin reuptake inhibitors, vincristine)
    • pulmonary diseases
      • infections (tuberculosis, acute bacterial and viral pneumonia, aspergillosis, empyema)
      • mechanical/ventilatory (acute respiratory failure, COPD, positive pressure ventilation)
  • prolonged strenuous exercise (marathon, triathalon, ultramarathon, hot-weather hiking)
  • idiopathic
  • glucocorticoid deficiency
  • hypothyroidism
  • water intoxication – primary polydipsia, excess intravenous hypotonic fluids (2)

Reference:

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