{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T08:42:28Z","timestamp":1771231348189,"version":"3.50.1"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"17","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Was ist neu?<\/jats:title><jats:p>\n          COVID-19 und St\u00f6rungen der Wasser- und Natriumhom\u00f6ostase\u2002Eine Dysnatri\u00e4mie tritt bei hospitalisierten Patient*innen mit COVID-19 geh\u00e4uft auf und ist mit einer erh\u00f6hten Mortalit\u00e4t und vermehrt septischen Verl\u00e4ufen assoziiert. Insbesondere eine profunde Hyponatri\u00e4mie kann auch Ausdruck f\u00fcr ein zugrunde liegendes Syndrom der inad\u00e4quaten AVP-Sekretion (SIADH) oder einen Cortisolmangel unter COVID-19-Infektion sein. Patient*innen mit bereits bekannten St\u00f6rungen des AVP-Systems \u2013 wie dem SIADH oder Diabetes insipidus \u2013 sind einem erh\u00f6hten Risiko einer mitunter schwerwiegenden Elektrolyt-Entgleisung unter COVID-19-Infektion ausgesetzt und sollten engmaschig kontrolliert werden.<\/jats:p><jats:p>\n          Hyponatri\u00e4mie unter Immun-Checkpoint-Blockade \u2013 nicht immer SIADH\u2002Der wachsende Einsatz von Immun-Checkpoint-Inhibitoren (ICI) in der Tumortherapie hat auch zu einem Zuwachs von immunvermittelten endokrinen Nebenwirkungen gef\u00fchrt. Diese k\u00f6nnen zeitlich sehr variabel, auch noch nach Beendigung einer ICI-Therapie, auftreten und initial eine unspezifische Klinik aufweisen. Als ein einfacher, allgemein verf\u00fcgbarer Biomarker und zugleich sensitives Warnsignal f\u00fcr m\u00f6gliche endokrine Nebenwirkungen kann die Hyponatri\u00e4mie dienen. Eine unklare und neu aufgetretene Hyponatri\u00e4mie unter ICI-Therapie sollte vor Diagnose eines SIADH stets abgekl\u00e4rt und endokrine Nebenwirkungen sollten ausgeschlossen werden.<\/jats:p><jats:p>\n          Neue Evidenz in der Behandlung der akuten und chronischen Hyponatri\u00e4mie\u2002In der Behandlung der akuten symptomatischen Hyponatri\u00e4mie eignen sich sowohl die rasche intermittierende Bolusgabe als auch die langsam kontinuierliche Infusion von 3\u200a% NaCl zur Akuttherapie. Die Bolusgabe bietet eine geringe \u00dcberlegenheit im Sicherheitsprofil und wird in den Empfehlungen der Europ\u00e4ischen Praxisleitlinie favorisiert. In der Behandlung der chronischen Hyponatri\u00e4mie bei SIADH ist die Fl\u00fcssigkeitsrestriktion als Erstlinientherapie ein probates Mittel zur Elektrolyt-Korrektur. Die additive Gabe von Furosemid und NaCl-Kapseln zeigt keine gesteigerte Wirkeffizienz, jedoch eine schlechtere Vertr\u00e4glichkeit.<\/jats:p><jats:p>\n          Copeptin-basierte Diagnostik in der Abkl\u00e4rung des Polyurie-Polydipsie-Syndroms\u2002Bei der Abkl\u00e4rung des Polyurie-Polydipsie-Syndroms ist die Sicherung einer hypotonen Polyurie vor der erweiterten diagnostischen Differenzierung essenziell. Copeptin-basierte Testverfahren zeigen eine deutliche \u00dcberlegenheit gegen\u00fcber dem indirekten Durstversuch in der Differenzierung zwischen Patient*innen mit einem Diabetes insipidus und einer Prim\u00e4ren Polydipsie. Das eskalierende Vorgehen der diagnostischen Verfahren ist ebenso zielf\u00fchrend wie ressourceneffizient.<\/jats:p>","DOI":"10.1055\/a-1783-3161","type":"journal-article","created":{"date-parts":[[2022,8,28]],"date-time":"2022-08-28T22:30:26Z","timestamp":1661725826000},"page":"1096-1103","source":"Crossref","is-referenced-by-count":4,"title":["SIADH &amp; Diabetes insipidus: Neues zu Diagnosestellung und Therapie"],"prefix":"10.1055","volume":"147","author":[{"given":"Wiebke","family":"Fenske","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fries","family":"Charlotte","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,8,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"599255","DOI":"10.3389\/fendo.2020.599255","article-title":"Prognostic Impact of Hyponatremia and Hypernatremia in COVID-19 Pneumonia. A HOPE-COVID-19 (Health Outcome Predictive Evaluation for COVID-19) Registry Analysis","volume":"11","author":"J G Ruiz-S\u00e1nchez","year":"2020","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e8841","DOI":"10.7759\/cureus.8841","article-title":"COVID-19 Pneumonia: An Emerging Cause of Syndrome of Inappropriate Antidiuretic Hormone","volume":"12","author":"M M Sheikh","year":"2020","journal-title":"Cureus"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1007\/s11102-021-01148-1","article-title":"COVID-19 and the pituitary","volume":"24","author":"S Frara","year":"2021","journal-title":"Pituitary"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.1681\/ASN.2016101139","article-title":"Diagnosis and Treatment of Hyponatremia: Compilation of the Guidelines","volume":"28","author":"E J Hoorn","year":"2017","journal-title":"J Am Soc Nephrol"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1101\/2020.06.08.139329","article-title":"The hypothalamus as a hub for SARS-CoV-2 brain infection and pathogenesis","author":"S Nampoothiri","year":"2020"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.21037\/atm-20-4281","article-title":"Analysis of 2019-nCoV receptor ACE2 expression in different tissues and its significance study","volume":"8","author":"T Han","year":"2020","journal-title":"Ann Transl Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.4103\/1673-5374.327323","article-title":"SARS-CoV-2 involvement in central nervous system tissue damage","volume":"17","author":"M A Haidar","year":"2022","journal-title":"Neural Regen Res"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e678","DOI":"10.1016\/j.wneu.2021.06.004","article-title":"Coronavirus Disease 2019 and Pituitary Apoplexy: A Single-Center Case Series and Review of the Literature","volume":"152","author":"R Martinez-Perez","year":"2021","journal-title":"World Neurosurg"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ando.2021.12.004","article-title":"COVID 19, the thyroid and the pituitary \u2013 The real state of play","author":"A Geslot","year":"2022","journal-title":"Ann Endocrinol (Paris)"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"184","DOI":"10.3390\/idr14020023","article-title":"COVID-19 and the Endocrine System: A Review of the Current Information and Misinformation","volume":"14","author":"S A Mirza","year":"2022","journal-title":"Infect Dis Rep"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"G9","DOI":"10.1530\/EJE-20-0338","article-title":"ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of diabetes insipidus and hyponatraemia","volume":"183","author":"M Christ-Crain","year":"2020","journal-title":"Eur J Endocrinol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"bvac036","DOI":"10.1210\/jendso\/bvac036","article-title":"It\u02bcs Not Always SIAD: Immunotherapy-Triggered Endocrinopathies Enter the Field of Cancer-Related Hyponatremia","volume":"6","author":"J Bischoff","year":"2022","journal-title":"J Endocr Soc"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1001\/jamainternmed.2020.5519","article-title":"Risk of Overcorrection in Rapid Intermittent Bolus vs Slow Continuous Infusion Therapies of Hypertonic Saline for Patients With Symptomatic Hyponatremia: The SALSA Randomized Clinical Trial","volume":"181","author":"S H Baek","year":"2021","journal-title":"JAMA Intern Med"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"101385","DOI":"10.1016\/j.beem.2020.101385","article-title":"Management of central diabetes insipidus","volume":"34","author":"A Garrahy","year":"2020","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1053\/j.ajkd.2019.11.012","article-title":"Efficacy of Furosemide, Oral Sodium Chloride, and Fluid Restriction for Treatment of Syndrome of Inappropriate Antidiuresis (SIAD): An Open-label Randomized Controlled Study (The EFFUSE-FLUID Trial)","volume":"76","author":"P Krisanapan","year":"2020","journal-title":"Am J Kidney Dis"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1111\/cen.13930","article-title":"Urea treatment in fluid restriction-refractory hyponatraemia","volume":"90","author":"J Lockett","year":"2019","journal-title":"Clin Endocrinol (Oxf)"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1111\/cen.13966","article-title":"Urea in cancer patients with chronic SIAD-induced hyponatremia: Old drug, new evidence","volume":"90","author":"A Nervo","year":"2019","journal-title":"Clin Endocrinol (Oxf)"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1627","DOI":"10.2215\/CJN.04020318","article-title":"Urea for the Treatment of Hyponatremia","volume":"13","author":"H Rondon-Berrios","year":"2018","journal-title":"Clin J Am Soc Nephrol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1053\/j.ajkd.2015.10.021","article-title":"Evaluation of Polyuria: The Roles of Solute Loading and Water Diuresis","volume":"67","author":"B Bhasin","year":"2016","journal-title":"Am J Kidney Dis"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1056\/NEJMoa1803760","article-title":"A Copeptin-Based Approach in the Diagnosis of Diabetes Insipidus","volume":"379","author":"W Fenske","year":"2018","journal-title":"N Engl J Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1016\/S0140-6736(19)31255-3","article-title":"Arginine-stimulated copeptin measurements in the differential diagnosis of diabetes insipidus: a prospective diagnostic study","volume":"394","author":"B Winzeler","year":"2019","journal-title":"The Lancet"}],"container-title":["DMW - Deutsche Medizinische Wochenschrift"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1783-3161.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,28]],"date-time":"2022-08-28T22:30:53Z","timestamp":1661725853000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1783-3161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,28]]},"references-count":21,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2022,8,28]]},"published-print":{"date-parts":[[2022,9]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1783-3161","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0012-0472","1439-4413"],"issn-type":[{"value":"0012-0472","type":"print"},{"value":"1439-4413","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,28]]}}}