This talk will discuss new diagnostic and therapeutic options in patients with the polyuria polydipsia syndrome on one side and in patients with the syndrome of inappropriate antidiuresis (SIAD) on the other side.
In polyuria polydipsia syndrome, central diabetes insipidus has to be differentiated from nephrogenic diabetes insipidus and from primary polydipsia. This differentiation is important since treatment differs and a wrong treatment can have serious consequences. For decades, the water deprivation test was the diagnostic gold standard, but its interpretation is often misleading. In this presentation, new osmotic and non-osmotic stimulation tests measuring copeptin, the C-terminal part of the vasopressin precursor will be discussed.
Also, a new medical treatment option in patients with primary polydipsia will be presented.
In patients with SIAD, copeptin as a potential new diagnostic marker in the differential diagnosis of hyponatremia and as a marker to predict neoplastic SIAD will be discussed. Treatment in SIAD is challenging and new treatment options are needed. Data concerning SGLT-2 inhibitors as a novel treatment option in patients with SIAD will be presented.