Reset osmostat
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Rest osmostat have been reported in a healthy patient[1].
Pathology
Reset osmostat may be a form of the syndrome of inappropriate antidiuretic hormone (SIADH) and has been proposed to possibly be either[2]:
- A type B SIADH. Type B SIADH may include reset osmostat, "characterized by a decline in plasma copeptin levels with increasing saline-stimulated serum osmolality...baseline hypovolemia could not be identified [in these patient]"[2]
- A type C SIADH. Reset osmostat may be a Type C rather than Type b, "reset osmostat may in part be considered as a less severe variant of the type C defect..., where responsivity to osmotic challenges is completely lost. Copeptin release in this subtype was stable at levels within the normal physiologic range but was not suppressed by hypotonicity or stimulated in response to osmotic stimulation; thus, it deviates from the previously described type C"[2]
Alternatively, reset osmostat may not be a type of SIADH[3].
Psychogenic polydipsia may be related to reset osmostat[4]
Diagnosis
The fractional urate excretion (FEurate) in reset osmostat should be: 4%-11% and is superior to serum urate[5].
Importance
Thiazide-type diurectics.
See also
External links
References
- ↑ Lipschutz JH, Arieff AI (1994). "Reset osmostat in a healthy patient". Ann Intern Med. 120 (7): 574–6. doi:10.7326/0003-4819-120-7-199404010-00007. PMID 8116995.
- ↑ 2.0 2.1 2.2 Fenske WK, Christ-Crain M, Hörning A, Simet J, Szinnai G, Fassnacht M; et al. (2014). "A copeptin-based classification of the osmoregulatory defects in the syndrome of inappropriate antidiuresis". J Am Soc Nephrol. 25 (10): 2376–83. doi:10.1681/ASN.2013080895. PMC 4178436. PMID 24722436.
- ↑ Maesaka JK, Imbriano L, Mattana J, Gallagher D, Bade N, Sharif S (2014). "Differentiating SIADH from Cerebral/Renal Salt Wasting: Failure of the Volume Approach and Need for a New Approach to Hyponatremia". J Clin Med. 3 (4): 1373–85. doi:10.3390/jcm3041373. PMC 4470189. PMID 26237607.
- ↑ Hariprasad MK, Eisinger RP, Nadler IM, Padmanabhan CS, Nidus BD (1980). "Hyponatremia in psychogenic polydipsia". Arch Intern Med. 140 (12): 1639–42. PMID 7458496.
- ↑ Imbriano LJ, Ilamathi E, Ali NM, Miyawaki N, Maesaka JK (2012). "Normal fractional urate excretion identifies hyponatremic patients with reset osmostat". J Nephrol. 25 (5): 833–8. doi:10.5301/jn.5000074. PMID 22307440.