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Hyponatremia in patients with cancer

Kitchlu, Abhijata; Rosner, Mitchell H.b

Current Opinion in Nephrology and Hypertension: September 2019 - Volume 28 - Issue 5 - p 433–440
doi: 10.1097/MNH.0000000000000525
PHARMACOLOGY AND THERAPEUTICS: Edited by Sankar D. Navaneethan

Purpose of review Hyponatremia is seen commonly in patients with cancer and is associated with increased mortality and morbidity. Understanding the proper diagnosis and therapy of cancer-associated hyponatremia is critical to ensure improved outcomes.

Recent findings The most common cancers associated with hyponatremia are the various forms of lung cancer with incidences approaching 25–45%. The most common causes of hyponatremia in cancer patients are the syndrome of inappropriate antidiuretic hormone secretion [syndrome of inappropriate antidiuretic hormone (ADH)] and volume depletion. Proper diagnosis rests on clinical information supplemented by laboratory studies and is critical to ensure appropriate therapy. In recent years, the development of drugs that specifically antagonize the vasopressin type 2 receptor in the distal tubule have offered targeted and highly effective therapies for syndrome of inappropriate ADH.

Summary Hyponatremia in cancer patients generally indicates advanced or severe disease but proper therapy that targets the underlying process can improve outcomes.

aDivision of Nephrology, Department of Medicine, University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada

bDivision of Nephrology, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia, USA

Correspondence to Mitchell H. Rosner, MD, Division of Nephrology, Department of Medicine, University of Virginia Health System, Box 800133, Charlottesville, VA 22908, USA. Tel: +1 434 982 6999; fax: +1 434 924 5848; e-mail:

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