Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presença de fatores de risco
- busca e ingestão de água
Outros fatores diagnósticos
- agitação
- poliúria
- cefaleia
- náuseas ou vômitos
- letargia ou confusão
- convulsões, delirium ou coma
Fatores de risco
- transtornos psiquiátricos
- transtornos do neurodesenvolvimento
- tabagismo
- abuso de álcool
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- osmolalidade plasmática
- osmolalidade urinária
- sódio urinário
- sódio sérico
- volume urinário de 24 horas
- urinálise
- ureia sérica
- teste de restrição de água
Investigações a serem consideradas
- teste de vasopressina
- hormônio antidiurético plasmático
Algoritmo de tratamento
hiponatremia grave (<125 mmol/L [<125 mEq/L]) ou com sintomas neurológicos
hiponatremia (125-130 mmol/L [125-130 mEq/L]) ou com sintomas gastrointestinais
polidipsia crônica
Colaboradores
Autores
Shilpa Srinivasan, MD, DFAPA, DFAAGP
Vice Chair, Medical Staff Affairs, Behavioral Health Midlands, Prisma Health
Professor of Clinical Psychiatry
Program Director: Geriatric Psychiatry Fellowship
Director: Psychiatry Acting Internship and M4 Clerkship
Department of Neuropsychiatry and Behavioral Science
Prisma Health - University of South Carolina School of Medicine Columbia
Columbia
SC
Declarações
SS is a board member of the American Association for Geriatric Psychiatry and serves on the Geriatric Psychiatry Exam Committee for the American Board of Psychiatry and Neurology.
Meera Narasimhan, MD, DFAPA
Professor and Chair
Department of Neuropsychiatry and Behavioral Science
Senior Medical Director
Prisma Health
Special Advisor to University of South Carolina President
Health Innovations and Economic Development
University of South Carolina School of Medicine Columbia
Columbia
SC
Declarações
MN is a member of an advisory board for Alkermes.
Agradecimentos
Dr Shilpa Srinivasan and Dr Meera Narasimhan would like to gratefully acknowledge Dr Emily Williams and Dr Brian Dundas, previous contributors to this topic.
Declarações
EW declares that she has no competing interests. BD is an author of one of the references for this topic.
Revisores
Branimir Margetić, MD
Neuropsychiatric Hospital "Dr Ivan Barbot"
Popovaca
Croatia
Declarações
BM is an author of a reference cited in this topic.
Aaron Pinkhasov, MD, DFAPA, FACLP
Chairman
Department Of Psychiatry
NYU Langone Hospital
Professor of Psychiatry and Medicine
NYU Long Island School of Medicine
Long Island
NY
Declarações
AP declares that he has no competing interests.
Richard C Millson, MD, DTM&H, FRCPC
Associate Professor of Psychiatry
Queen's University
Kingston
Ontario
Canada
Declarações
RCM declares that he has no competing interests. He is the author of some of the references cited in this topic.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Ahmadi L, Goldman MB. Primary polydipsia: update. Best Pract Res Clin Endocrinol Metab. 2020 Sep;34(5):101469.Texto completo Resumo
Sterns RH. Disorders of plasma sodium - causes, consequences, and correction. N Engl J Med. 2015 Jan 1;372(1):55-65. Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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