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J Clin Med. 2014 Sep 18;3(3):1043-9. doi: 10.3390/jcm3031043.

Actual Therapeutic Indication of an Old Drug: Urea for Treatment of Severely Symptomatic and Mild Chronic Hyponatremia Related to SIADH.

Author information

1
Departments of Internal Medicine, Erasmus University Hospital, Route de Lennik, 808, Brussels B-1070, Belgium. guy.decaux@skynet.be.
2
Departments of Nephrology, Erasmus University Hospital, Brussels B-1070, Belgium. fabrice.gankam@erasme.ulb.ac.be.
3
Departments of Internal Medicine, Erasmus University Hospital, Route de Lennik, 808, Brussels B-1070, Belgium. bruno.couturier@erasme.ulb.ac.be.
4
Departments of Internal Medicine, Erasmus University Hospital, Route de Lennik, 808, Brussels B-1070, Belgium. frederic.vandergheynst@erasme.ulb.ac.be.
5
Department of Internal Medicine, Bracops Hospital, Brussels B-1070, Belgium. wim.musch@numericable.be.
6
Departments of Internal Medicine, Erasmus University Hospital, Route de Lennik, 808, Brussels B-1070, Belgium. alain.soupart@entitejolimontoise.be.
7
Department of Internal Medicine, Jolimont/Tubize Hospital, Tubize 1480, Belgium. alain.soupart@entitejolimontoise.be.

Abstract

Oral urea has been used in the past to treat various diseases like gastric ulcers, liver metastases, sickle cell disease, heart failure, brain oedema, glaucoma, Meniere disease, etc. We have demonstrated for years, the efficacy of urea to treat euvolemic (SIADH) or hypervolemic hyponatremia. We briefly describe the indications of urea use in symptomatic and paucisymptomatic hyponatremic patients. Urea is a non-toxic, cheap product, and protects against osmotic demyelinating syndrome (ODS) in experimental studies. Prospective studies showing the benefit to treat mild chronic hyponatremia due to SIADH and comparing water restriction, urea, high ceiling diuretics, and antivasopressin antagonist antagonist should be done.

KEYWORDS:

ODS; SIADH; V2 antagonist; high ceiling diuretics; hyponatremia; urea

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