Diabetes insipidus (DI) is a form of polyuria-polydipsia syndrome characterised by excretion large amounts hypotonic urine and excessive drinking.1,2 Given the challenges in investigation syndrome,3 web-based clinical decision support tool ‘The PP App’ (https://pathologyapps.shinyapps.io/PolyuriaPolydipsia/) has been created with up-to-date evidence-based information. In this Shiny app, initial...

Hyponatremia has been associated with several antiepileptic drugs (AEDs), such as carbamazepine, oxcarbazepine, and occasionally with valproate and lamotrigine. 1,2 To date, there is only a report of hyponatremia associated with levetiracetam in a 65-year-old patient predisposed to the development of syndrome of inappropriate antidiuretic hormone secretion (SIADH). 3 We recently observed a pati...

A 68-year-old woman was admitted to determine the pathogenesis of weight loss and polyuria. Physical findings on admission showed BMI of 20.9, blood pressure of 147/69 mmHg, and that she had ciliac, axillar and pubic hair loss. Laboratory findings showed that plasma adrenocorticotropic hormone (ACTH) was 4.6 pg/mL with serum cortisol of 1.2 µg/dL. Serum luteinizing hormone (LH) and follicle-sti...

Hyponatremia is defined by low serum sodium concentration and is the most common electrolyte disorder encountered in clinical practice. Serum sodium is the main determinant of plasma osmolality, which, in turn, affects cell volume. In the presence of low extracellular osmolality, cells will swell if the adaptation mechanisms involved in the cell volume maintenance are inadequate. The most drama...

Terlipressin, an analogue of vasopressin, is frequently used for the management of esophageal varices bleeding and hepatorenal syndrome. Terlipressin therapy in portal hypertensive patients is frequently associated with hyponatremia, but is rarely accompanied with serious neurological manifestations. A 39-year-old female with pancreatic neuroendocrine tumor, liver metastasis, main portal vein t...

While some electrolyte disturbances are immediately life-threatening and must be emergently treated, others may be delayed without immediate adverse consequences. We discuss a patient with alcoholism and diabetes mellitus type 2 who presented with volume depletion and multiple life-threatening electrolyte and metabolic derangements including severe hyponatremia (serum sodium concentration [SNa]...

Hydration status is linked with health, wellness, and performance. We evaluated hydration status, water intake, and urine output for seven consecutive days in healthy adults. Volunteers living in Spain, Germany, or Greece (n = 573, 39 ± 12 years (51.1% males), 25.0 ± 4.6 kg/m² BMI) participated in an eight-day study protocol. Total water intake was estimated from seven-day food and drink diarie...

Background: The ratio of urine protein to urine osmolality has recently been suggested as an accurate method to determine proteinuria.  Objective: We studied the correlation of urine protein to urine osmolality ratio with 24-hr urinary protein excretion. Methods: 150 children aged 0.11–17 years admitted to the Department of Pediatric Nephrology were included in this study. Early morning urine s...

BACKGROUND AND OBJECTIVES During pregnancy, the body exhibits dynamic changes in fluid composition. More than 50%of women experience nausea and vomiting during the first trimester. Studies of hydration status in pregnant women are limited, and not in tropical countries, like in Indonesia. The objective of this study was to investigate the hydration status and appropriate biomarkers for determin...

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) results from the aberrant or sustained secretion of the antidiuretic hormone. Classic manifestations include water retention, hyponatremia, and hypo-osmolality of the serum. Treatment is aimed at differentiating SIADH from other causes of hyponatremia, determining the underlying disorder, and alleviating the excessive water re...