nach oben

Supportive Care in Cancer

Erschienen in:

01.12.2007 | Review Article

Diagnosis and management of hyponatremia in cancer patients

verfasst von: Harry Raftopoulos

Erschienen in: Supportive Care in Cancer | Ausgabe 12/2007

Einloggen, um Zugang zu erhalten

Abstract

Background

Hyponatremia is among the metabolic disturbances encountered in oncology. Risk factors for hyponatremia include chemotherapy, treatment-induced nausea and vomiting, hydration, pain, narcotic drugs, and physical and emotional stress. A common cause of hyponatremia in patients with cancer is the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), which may result from ectopic production of arginine vasopressin (AVP) by the tumor tissue.

Treatment

The AVP-receptor antagonists, a new class of agents, correct hyponatremia by directly blocking the binding of AVP with its receptors. In clinical trials, conivaptan, lixivaptan, tolvaptan, and satavaptan have increased serum osmolality and normalized the serum [Na⁺] in hyponatremia associated with SIADH, cirrhosis, or congestive heart failure. These drugs may have a potential in cancer-related hyponatremia as well.

Adrogué HJ, Madias NE (2000) Hyponatremia. N Engl J Med 342:1581–1589PubMedCrossRef

Anderson RJ, Chung H-M, Kluge R, Schrier RW (1985) Hyponatremia: a prospective analysis of its epidemiology and the pathogenetic role of vasopressin. Ann Intern Med 102:164–168PubMed

Bartter FC, Schwartz WB (1967) The syndrome of inappropriate secretion of antidiuretic hormone. Am J Med 42:790–806PubMedCrossRef

Baylis PH (1989) Regulation of vasopressin secretion. Baillieres Clin Endocrinol Metab 3:313–330PubMedCrossRef

Baylis PH (2003) The syndrome of inappropriate antidiuretic hormone secretion. Int J Biochem Cell Biol 35:1495–1499PubMedCrossRef

Berghmans T (1996) Hyponatremia related to medical anticancer treatment. Support Care Cancer 4:341–350PubMedCrossRef

Berghmans T, Paesmans M, Body JJ (1999) A prospective study on hyponatraemia in medical cancer patients: epidemiology, aetiology and differential diagnosis. Support Care Cancer 8:192–197CrossRef

Berry PL, Belsha CW (1990) Hyponatremia. Pediatr Clin North Am 37:351–363PubMed

Bissett D, Cornford EJ, Sokal M (1989) Hyponatraemia following cisplatin chemotherapy. Acta Oncol 28:823PubMed

10.

Bliss DP Jr, Battey JF, Linnoila RI, Birrer MJ, Gazdar AF, Johnson BE (1990) Expression of the atrial natriuretic factor gene in small cell lung cancer tumors and tumor cell lines. J Natl Cancer Inst 82:305–310PubMedCrossRef

11.

Boku N, Ohtsu A, Nagashima F, Muto M, Shinkai T, Yoshida A (2001) Retrospective study of hyponatremia in gastric cancer patients treated with a combination chemotherapy of 5-fluorouracil and cisplatin: a possible warning sign of severe hematological toxicities? Jpn J Clin Oncol 31:382–387PubMedCrossRef

12.

Campling BG, Sarda IR, Baer KA, Pang SC, Baker HM, Lofters WS, Flynn TG (1995) Secretion of atrial natriuretic peptide and vasopressin by small cell lung cancer. Cancer 75:2442–2451PubMedCrossRef

13.

Cancer Therapy Evaluation Program (2006) Common terminology criteria for adverse events, version 3.0. DCTD, NCI, NIH, DHHS; March 31, 2003. Available at: http://ctep.cancer.gov. Publish date: August 9, 2006. Accessed on November 15, 2006

14.

Cao L, Joshi P, Sumoza D (2002) Renal salt-wasting syndrome in a patient with cisplatin-induced hyponatremia: case report. Am J Clin Oncol 25:344–346PubMedCrossRef

15.

Comis RL, Miller M, Ginsberg SJ (1980) Abnormalities in water homeostasis in small cell anaplastic lung cancer. Cancer 45:2414–2421PubMedCrossRef

16.

Decaux G, Soupart A (2003) Treatment of symptomatic hyponatremia. Am J Med Sci 326:25–30PubMedCrossRef

17.

Dhaliwal HS, Rohatiner AZS, Gregory W, Richards MA, Johnson PWM, Whelan JS, Gallagher CJ, Matthews J, Ganesan TS, Barnett MJ, Waxman JH, Stansfeld AG, Wrigley PFM, Slevin ML, Malpas JS, Lister TA (1993) Combination chemotherapy for intermediate and high grade non-Hodgkin’s lymphoma. Br J Cancer 68:767–774PubMed

18.

el Weshi A, Thieblemont C, Cottin V, Barbet N, Catimel G (1995) Cisplatin-induced hyponatremia and renal sodium wasting. Acta Oncol 34:264–265PubMed

19.

Elisaf MS, Konstantinides A, Siamopoulos KC (1996) Chronic hyponatremia due to reset osmostat in a patient with colon cancer. Am J Nephrol 16:349–351PubMed

20.

Ellis SJ (1995) Severe hyponatraemia: complications and treatment. QJM 88:905–909PubMed

21.

Fried LF, Palevsky PM (1997) Hyponatremia and hypernatremia. Med Clin North Am 81:585–609PubMedCrossRef

22.

Gerbes AL, Gulberg V, Gines P, Decaux G, Gross P, Gandjini H, Djian J (2003) Therapy of hyponatremia in cirrhosis with a vasopressin receptor antagonist: a randomized double-blind multicenter trial. Gastroenterology 124:933–939PubMedCrossRef

23.

Ghali JK, Koren MJ, Taylor JR, Brooks-Asplund E, Fan K, Long WA, Smith N (2006) Efficacy and safety of oral conivaptan: a vasopressin receptor V_1A/V₂ antagonist, assessed in a randomized, placebo-controlled trial in patients with euvolemic or hypervolemic hyponatremia. J Clin Endocrinol Metab 91:2145–2152PubMedCrossRef

24.

Gheorghiade M, Niazi I, Ouyang J, Czerwiec F, Kambayashi J, Zampino M, Orlandi C (2003) Vasopressin V₂-receptor blockade with tolvaptan in patients with chronic heart failure: results from a double-blind, randomized trial. Circulation 107:2690–2696PubMedCrossRef

25.

Gheorghiade M, Gattis WA, O’Connor CM, Adams KF Jr, Elkayam U, Barbagelata A, Ghali JK, Benza RL, McGrew FA, Klapholz M, Ouyang J, Orlandi C (2004) Effects of tolvaptan, a vasopressin antagonist, in patients hospitalized with worsening heart failure: a randomized controlled trial. JAMA 291:1963–1971PubMedCrossRef

26.

Glover DJ, Glick JH (1987) Metabolic oncologic emergencies. CA Cancer J Clin 37:302–320PubMedCrossRef

27.

Goh KP (2004) Management of hyponatremia. Am Fam Phys 69:2387–2394

28.

Gross AJ, Steinberg SM, Reilly JG, Bliss DP Jr, Brennan J, Le PT, Simmons A, Phelps R, Mulshine JL, Ihde DC, Johnson BE (1993) Atrial natriuretic factor and arginine vasopressin production in tumor cell lines from patients with lung cancer and their relationship to serum sodium. Cancer Res 53:67–74PubMed

29.

Gross P, Reimann D, Henschkowski J, Damian M (2001) Treatment of severe hyponatremia: conventional and novel aspects. J Am Soc Nephrol 12:S10–S14PubMed

30.

Gross P, Bisaha JG, Smith N (2004) Conivaptan, a novel V_1A and V₂ antagonist, increased serum sodium and effective water clearance in patients with euvolemic or hypervolemic hyponatremia [abstract]. J Am Soc Nephrol 15:355A, Abstract SA-P0243CrossRef

31.

Gullans SR, Verbalis JG (1993) Control of brain volume during hyperosmolar and hypoosmolar conditions. Annu Rev Med 44:289–301PubMedCrossRef

32.

Iyer AV, Krasnow SH, Dufour R, Arcenas AS (2003) Sodium-wasting nephropathy caused by cisplatin in a patient with small-cell lung cancer. Clin Lung Cancer 5:187–189PubMedCrossRef

33.

Kinzie BJ (1987) Management of the syndrome of inappropriate secretion of antidiuretic hormone. Clin Pharm 6:625–633PubMed

34.

Langfeldt LA, Cooley ME (2003) Syndrome of inappropriate antidiuretic hormone secretion in malignancy: review and implications for nursing management. Clin J Oncol Nurs 7:425–430PubMedCrossRef

35.

List AF, Hainsworth JD, Davis BW, Hande KR, Greco FA, Johnson DH (1986) The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in small-cell lung cancer. J Clin Oncol 4:1191–1198PubMed

36.

Nielsen S (2002) Renal aquaporins: an overview. BJU Int 90(Suppl 3):1–6PubMedCrossRef

37.

Østerlind K (1994) Factors confounding evaluation of treatment effect in lung cancer. Lung Cancer 10(Suppl 1):S97–S103PubMedCrossRef

38.

Palmer BF (2003) Hyponatremia in patients with central nervous system disease: SIADH versus CSW. Trends Endocrinol Metab 14:182–187PubMedCrossRef

39.

Poe CM, Taylor LM (1989) Syndrome of inappropriate antidiuretic hormone: assessment and nursing implications. Oncol Nurs Forum 16:373–381PubMed

40.

Renneboog B, Musch W, Vandemergel X, Manto MU, Decaux G (2006) Mild chronic hyponatremia is associated with falls, unsteadiness, and attention deficits. Am J Med 119:71.e1–71.e8CrossRef

41.

Robertson GL (2001) Antidiuretic hormone. Normal and disordered function. Endocrinol Metab Clin North Am 30:671–694PubMedCrossRef

42.

Schrier RW, Gross P, Gheorghiade M, Berl T, Verbalis JG, Czerwiec FS, Orlandi C, for the SALT Investigators (2006) Tolvaptan, a selective oral vasopressin V2-receptor antagonist, for hyponatremia. N Engl J Med 355:2099–2112PubMedCrossRef

43.

Schwartz WB, Bennett W, Curelop S, Bartter FC (1957) A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone. Am J Med 23:529–542PubMedCrossRef

44.

Silverman P, Distelhorst CW (1989) Metabolic emergencies in clinical oncology. Semin Oncol 16:504–515PubMed

45.

Sørensen JB, Andersen MK, Hansen HH (1995) Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in malignant disease. J Intern Med 238:97–110PubMedCrossRef

46.

Soupart A, Gross P, Legros JJ, Alfoldi S, Annane D, Heshmati HM, Decaux G (2006) Successful long-term treatment of hyponatremia in syndrome of inappropriate antidiuretic hormone secretion with satavaptan (SR121463B), an orally active nonpeptide vasopressin V2-receptor antagonist. Clin J Am Soc Nephrol 1:634–640CrossRef

47.

Vanhees SL, Paridaens R, Vansteenkiste JF (2000) Syndrome of inappropriate antidiuretic hormone associated with chemotherapy-induced tumour lysis in small-cell lung cancer: case report and literature review. Ann Oncol 11:1061–1065PubMedCrossRef

48.

Verbalis JG (2002) Vasopressin V₂ receptor antagonists. J Mol Endocrinol 29:1–9PubMedCrossRef

49.

Wong F, Blei AT, Blendis LM, Thuluvath PJ (2003) A vasopressin receptor antagonist (VPA-985) improves serum sodium concentration in patients with hyponatremia: a multicenter, randomized, placebo-controlled trial. Hepatology 37:182–191PubMedCrossRef

50.

Zeltser D, Rosansky S, van Rensburg H, Verbalis JG, Smith N (2007) Assessment of the efficacy and safety of intravenous conivaptan in euvolemic and hypervolemic hyponatremia. Am J Nephrol 27:447–457PubMedCrossRef

Titel: Diagnosis and management of hyponatremia in cancer patients
verfasst von: Harry Raftopoulos
Publikationsdatum: 01.12.2007
Verlag: Springer-Verlag
Erschienen in: Supportive Care in Cancer / Ausgabe 12/2007
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-007-0309-9

Springer Medizin

Diagnosis and management of hyponatremia in cancer patients

Abstract

Background

Treatment

Neu im Fachgebiet Onkologie

Adjuvante Immuntherapie verlängert Leben bei RCC

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

Bei Senioren mit Prostatakarzinom auf Anämie achten!

ICI-Therapie in der Schwangerschaft wird gut toleriert

Update Onkologie

Springer Medizin

Abstract

Background

Treatment

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 12/2007

Dying at home or in an institution: perspectives of Dutch physicians and bereaved relatives

High-dose corticosteroids for the management of dyspnea in patients with tumor obstruction of the upper airway

Oxidative stress in lymphocytes, neutrophils, and serum of oral cavity cancer patients: modulatory array of l-glutamine

Endocrine symptom assessment in women with breast cancer: what a simple “yes” means

Sources of strength perceived by females caring for relatives diagnosed with cancer: an exploratory study from India

A meta-analysis of exercise interventions among people treated for cancer

Neu im Fachgebiet Onkologie

Adjuvante Immuntherapie verlängert Leben bei RCC

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

Bei Senioren mit Prostatakarzinom auf Anämie achten!

ICI-Therapie in der Schwangerschaft wird gut toleriert

Update Onkologie