What are the diagnostic criteria for syndrome of inappropriate antidiuretic hormone secretion (SIADH)?

Updated: Aug 16, 2019
  • Author: Christie P Thomas, MBBS, FRCP, FASN, FAHA; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

In the absence of a single laboratory test to confirm the diagnosis, the syndrome of inappropriate antidiuretic hormone secretion (SIADH) is best defined by the classic criteria introduced by Bartter and Schwartz in 1967, which remain valid today. The criteria can be summarized as follows [2] :

  • Hyponatremia with corresponding hypoosmolality

  • Continued renal excretion of Na+

  • Urine less than maximally dilute

  • Absence of clinical evidence of volume depletion - Normal skin turgor, blood pressure within the reference range

  • Absence of other causes of hyponatremia - Adrenal insufficiency (mineralocorticoid deficiency, glucocorticoid deficiency), hypothyroidism, cardiac failure, pituitary insufficiency, renal disease with salt wastage, hepatic disease, drugs that impair renal water excretion

  • Correction of hyponatremia by fluid restriction


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