[Fluctuating hyponatremia following transsphenoidal surgery ‒ "The challenge of correcting without going too far"].

Authors

Elena Vera Tuñón, Luis Casamayor Escrivá

Published in

Nutricion hospitalaria. Sep 02, 2026. Epub Sep 02, 2026.

Abstract

sodium disorders following pituitary represent one of the most common complications. Differential diagnosis between syndrome of inappropriate antidiuretic hormone secretion (SIADH) and a triphasic response is critical to avoid overcorrection.
we report a case of a 58-year-old male who underwent surgery for a pituitary macroadenoma and developed a triphasic response: initial polyuria, followed by transient SIADH. Due to a suboptimal response to fluid restriction and the risk of transitioning to a new polyuric phase, oral urea (30 g/day) was started. Gradual and safe sodium correction was achieved (128 to 132 mmol/l in 36 h), allowing early detection of the final shift back to diabetes insipidus without exceeding safety limits.
all in all, oral urea is an effective alternative for postoperative SIADH, providing more predictable and reversible osmotic control in scenarios of fluctuating natremia.

PMID:
42704004
Bibliographic data and abstract were imported from PubMed on 07 Sep 2026.

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