ArticleCureus2020
The Role of Fractional Excretion of Uric Acid in the Differential Diagnosis of Hypotonic Hyponatraemia in Patients with Diuretic Therapy.
Article in Cureus, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 19 citations in OpenAlex.
- Hyponatraemic seizure in a healthy adult due to stress-associated non-osmotic vasopressin-mediated antidiuresis on a low-solute background: a case report.International journal of emergency medicine · 2026Article
- Pathophysiology, symptoms, outcomes, and evaluation of hyponatremia: comprehension and best clinical practice.Clinical and experimental nephrology · 2025Review
- Mechanism and use strategy of uric acid-lowering drugs on coronary heart disease.International journal of cardiology. Heart & vasculature · 2024Review
- Euvolemic hypotonic hyponatremia in SIAD and thiazide-treated patients: similarities and differences.Journal of nephrology · 2024Article
- Ameliorative action of "daitongxiao" against hyperuricemia includes the "uric acid transporter group".Frontiers in pharmacology · 2024Article
- New Approach to Hyponatremia: High Prevalence of Cerebral/Renal Salt Wasting, Identification of Natriuretic Protein That Causes Salt Wasting.Journal of clinical medicine · 2022Review
- Korean Society of Nephrology 2022 recommendations on controversial issues in diagnosis and management of hyponatremia.The Korean journal of internal medicine · 2022Review
- Korean Society of Nephrology 2022 Recommendations on controversial issues in diagnosis and management of hyponatremia.Kidney research and clinical practice · 2022Article
- Korean Society of Nephrology 2022 Recommendations on Controversial Issues in Diagnosis and Management of Hyponatremia.Electrolyte & blood pressure : E & BP · 2022Review
- A historical journey of searching for uricosuric drugs.Clinical rheumatology · 2022Review
- The Combined Use of Fractional Urate and Potassium Excretion in the Diagnosis of Diuretic-Induced Hyponatremia.Cureus · 2021Article
- Syndrome of inappropriate antidiuretic hormone secretion in a patient with pituitary apoplexy.BMJ case reports · 2021Article
- Integrating Physiology Into Hyponatremia Algorithms: Moving Beyond Volume Status.Journal of investigative medicine high impact case reportsArticle
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Authors and funding
2 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
Hyponatraemia is the most common electrolyte imbalance found in hospital population and worldwide thiazide and loop-diuretics are among the most widely used drugs. Syndrome of inappropriate antidiuresis diagnosis (SIAD) is complicated in the presence of diuretic therapy due to the misleading clinical assessment of the extracellular volume status, and in order to make SIAD diagnosis it is often necessary to withdraw diuretic therapy. Our study aimed to investigate the diagnostic role of these alternative markers of volume status, serum uric acid (sUA) and fractional excretion of uric acid (FEUA), in hyponatraemic patients treated with different diuretic drugs. Eighty-nine patients were enrolled with the diagnosis of SIAD, diuretic-induced hyponatremia (DIH, treated with furosemide and potassium canrenoate) or thiazide-induced hyponatremia (TIH, treated with hydrochlorothiazide, metolazone or indapamide) and investigated with receiver operating characteristic analysis and a sensitivity test. Our results show that FEUA discriminated better than sUA between SIAD and DIH patients (area under curve 0.96, <0.001 vs. 0.88, <0.001) while it was a poor marker to discriminate between SIAD and TIH (0.65, NS vs. 0.67, NS). In conclusions, FEUA is an excellent marker to discriminate SIAD vs. sodium depleted patients treated with furosemide and/or potassium canrenoate while the diuretic withdrawal, beyond obtaining a serum Na normalization, is still mandatory for differential diagnosis of sodium depleted patients affected by thiazide-induced hyponatraemia.
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