Cancer Associated Hyponatremia, Using a physiological Approach to Diagnostics and Therapeutics
CCCF ePoster library. Umar Sharif M. Oct 27, 2015; 117303; P85 Disclosure(s): Nothing to declare
Dr. Mohammad Ali Shafiee Umar Sharif
Dr. Mohammad Ali Shafiee Umar Sharif
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Topic: Retrospective or Prospective Cohort Study

Cancer Associated Hyponatremia, Using a physiological Approach to Diagnostics and Therapeutics

Umar Sharif, B. Dastgheib

Division of Medicine, Toronto General Hospital, Toronto, Canada | Surgery, St. Michael's Hospital, Toronto, Canada


Hyponatremia is the most common electrolyte abnormality encountered in cancer patients admitted to medical wards in hospital and is associated with poorer outcome and reduced quality of life. The most common cause of hyponatremia in cancer patients is thought to be the syndrome of inappropriate antidiuretic hormone (SIADH) due to ectopic secretion of ADH by cancer cells. At other times hyponatremia is often seen as an incidental finding in oncology patients that is often underdiagnosed and undertreated leading to higher morbidity in this group which may be due to misapprehension of its clinical significance.


To determine the association of different cancers to the degree of hyponatremia in males and females. To determine the most common cancer process leading to hyponatremia. Additionally, to determine the most common underlying mechanism of hyponatremia in cancer patients admitted to hospital.


Using a retrospective analysis of 92 patients admitted to General Internal Medicine ward, the study aimed to stratify hyponatremic cancer patients into physiological categories based on underlying processes at play. Using clinical history, type of cancer along with plasma and urine osmolality measurements, patients were stratified into physiological categories


It was found that the majority of hyponatremia arising in cancer was due to decreased osmole intake rather than ectopic ADH secretion. Other causes of hyponatremia were found to be: reset osmostat, enhanced ADH action which could be due to osmotic or non-osmotic stimuli as well as drugs through various mechanisms. The most frequent cancers associated with hyponatremia in this study are primary lung malignancies. This was followed by hematological malignancies and liver malignancies. Severity of hyponatremia was not linked to the malignancy type.

Conclusion: Adequate management and improved health outcomes of hyponatremia in cancer patients may be achieved only by specifically tailored therapy geared toward the underlying physiological process. Severity of hyponatremia was not found to be directly linked to the malignancy type.


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