Diabet insipid vs SIADH

	Diabetul insipid	SIADH
Fiziopatologie	Lipsa ADH	Exces ADH
Etiologie	Neurogenica – lipsa de secretie ADH Nefrogenica – insensibitate la ADH	Secretia crescuta in ciuda osmolaritatii serice scazute
Cauze	Neurologice TCC/Chirurgie cerebrala Sarcoidoza Tumoare cerebrala – Craniofaringeom/Pinealom/Meningeom/Disgerminom/ Glanda pituitara Nefrologice Hipopotasemie Hipercalcemie Hipotermie Insuficienta renal cronica Litiu Alcool	TCC/ Tumori SNC Post-chirurgical Producere ectopica tumorala B hepatica Cancer pulmonar/B pulmonara Hipotiroidism Insuficieta CSR
Semne si simptome	Modificari status mental Slabiciune, letargie, convulsii, coma Deshidratare, poliurie, polidipsie HIPERSODEMIE Modificari status mental Slabiciune, letargie, convulsii, coma Deshidratare, poliurie, polidipsie	Modificari status mental Cefalee, greata, voma, convulsii, coma Edem cerebral HIPOSODEMIE (<130 mEq/l) Osmolaritate urinara crescuta Diureza scazuta Hipo-osmolaritate (<270 mOsm/l) Na urinar > 20 mEq/l Scade BUN, Cr, albumina
Tratament	G 0,5 % Neurogenic – vasopresina /desmopresina/ Chlorpropamide (↑ eliberarea ADH) Nefrogenic – HCTZ	SF 0,9 % Restrictie fluide Demeclocycline

ADH = hormon antidiuretic

SIADH = sindromul secretiei inadecvate de hormon antidiuretic

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