[When growth hormone levels drop - Management with urea of postoperative inappropriate antidiuretic hormone secretion syndrome in a patient who underwent surgery for acromegaly].

Authors

Cristina Guillén, Ada María Roldán Sánchez, María Eugenia Torregrosa-Quesada, Javier Abarca, Elena García Garrigós, Antonio Picó Alfonso

Published in

Nutricion hospitalaria. Sep 01, 2026. Epub Sep 01, 2026.

Abstract

postoperative hyponatremia is a common complication after endoscopic transsphenoidal surgery, with an incidence of 9-35 % that rises to 41.5 % in patients with acromegaly.
a 74-year-old woman diagnosed with acromegaly underwent endoscopic transsphenoidal surgery and developed severe symptomatic hyponatremia (sodium 117 mmol/l) due to SIADH on postoperative day 11, after other causes of postoperative hyponatremia were ruled out. Following initial correction with hypertonic saline, treatment with oral urea (15 g/day) was started, achieving a safe increase in serum sodium (133 mmol/l at 48 hours) that allowed hospital discharge. One week later, with normalized sodium levels (137 mmol/l), treatment was withdrawn without subsequent recurrence.
oral urea is an effective, well-tolerated and cost-effective first-line treatment for SIADH after pituitary surgery, particularly relevant in patients with acromegaly given their higher incidence of late hyponatremia. Systematic sodium monitoring during the highest-risk period could allow earlier treatment initiation and prevent progression to severe cases.

PMID:
42704007
Bibliographic data and abstract were imported from PubMed on 07 Sep 2026.

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