When is urea used in the treatment of chronic 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

Urea is a solute that must be excreted by the kidneys. Because urine osmolality is fixed in persons with SIADH, the obligatory urine volume can be increased by increasing the osmotic or solute load. Increased urinary loss of water decreases free water retention. This therapy can be used in chronic and acute settings if the urine osmolality is low and can increase the serum Na+ by up to 5 mEq/L/day. Urea is a relatively nontoxic compound and, as opposed to sodium chloride treatment, does not cause edema or increase body weight.


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