SIADH vs DI
SIADH DI
Body is making too much ADH
Not enough ADH in the body
Too much antidiuresis → kidneys Without ADH to tell the body to hold
HOLD ON to water
Patho
onto water, the kidneys produce
Decreased UOP & retention of HUGE amounts of urine
water in the intravascular space
Leads to fluid volume deficit
ONLY water is retained - not
(hypotension, shock)
sodium (body remains euvolemic)
Weight gain Lack of concentration, memory, focus
NO peripheral edema
Assessment
Dry eyes/mouth, extreme thirst
Anorexia
Nausea Tachycardia
Vomiting Hypotension
Low serum sodium Muscle cramps
Irritability Large amounts of urine
Confusion
Weight loss
Hallucinations
Seizures (Na < 125) Lightheadedness/headaches
Urine = concentrated
↓ urine output Urine = dilute
↑
Lab Findings
↑
urine osmolality ↓ USG
↑
urine specific gravity
urine sodium
↓ urine osmolarity
Blood = dilute Blood = concentrated
↑ blood volume ↑ serum Na
Decreased blood osmolality ↑ serum osmolarity
Hyponatremia Serum Hct > 40%
Anemia
Monitor neuro status
Treatment
Monitor serum sodium
Sodium replacement Replace fluids
Seizure precautions Monitor hourly urine output
Replace volume + maintenance IV
Fluid restriction fluids
Hypertonic saline Vasopressin/desmopressin
SIADH DI
Body is making too much ADH
Not enough ADH in the body
Too much antidiuresis → kidneys Without ADH to tell the body to hold
HOLD ON to water
Patho
onto water, the kidneys produce
Decreased UOP & retention of HUGE amounts of urine
water in the intravascular space
Leads to fluid volume deficit
ONLY water is retained - not
(hypotension, shock)
sodium (body remains euvolemic)
Weight gain Lack of concentration, memory, focus
NO peripheral edema
Assessment
Dry eyes/mouth, extreme thirst
Anorexia
Nausea Tachycardia
Vomiting Hypotension
Low serum sodium Muscle cramps
Irritability Large amounts of urine
Confusion
Weight loss
Hallucinations
Seizures (Na < 125) Lightheadedness/headaches
Urine = concentrated
↓ urine output Urine = dilute
↑
Lab Findings
↑
urine osmolality ↓ USG
↑
urine specific gravity
urine sodium
↓ urine osmolarity
Blood = dilute Blood = concentrated
↑ blood volume ↑ serum Na
Decreased blood osmolality ↑ serum osmolarity
Hyponatremia Serum Hct > 40%
Anemia
Monitor neuro status
Treatment
Monitor serum sodium
Sodium replacement Replace fluids
Seizure precautions Monitor hourly urine output
Replace volume + maintenance IV
Fluid restriction fluids
Hypertonic saline Vasopressin/desmopressin
