Hyponatraemia (serum Na <135 mmol/L or <135 mEq/L) is the most common electrolyte disorder encountered in clinical practice.[4]Spasovski G, Vanholder R, Allolio B, et al. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Eur J Endocrinol. 2014 Mar;170(3):G1-47.
https://academic.oup.com/ejendo/article/170/3/G1/6668028
http://www.ncbi.nlm.nih.gov/pubmed/24569125?tool=bestpractice.com
[5]Ball S, Barth J, Levy M, et al. Society for Endocrinology endocrine emergency guidance: emergency management of severe symptomatic hyponatraemia in adult patients. Endocr Connect. 2016 Sep;5(5):G4-6.
https://pmc.ncbi.nlm.nih.gov/articles/PMC5314809
http://www.ncbi.nlm.nih.gov/pubmed/27935814?tool=bestpractice.com
It has been reported to occur in 15% to 28% of hospitalised patients.[6]Verbalis JG, Adler S, Schrier RW, et al. Efficacy and safety of oral tolvaptan therapy in patients with the syndrome of inappropriate antidiuretic hormone secretion. Eur J Endocrinol. 2011 May;164(5):725-32.
https://www.doi.org/10.1530/EJE-10-1078
http://www.ncbi.nlm.nih.gov/pubmed/21317283?tool=bestpractice.com
However, the incidence of clinically significant cases of hyponatraemia (serum Na <130 mmol/L or <130 mEq/L) is between 1% and 4%.[7]Verbalis JG, Goldsmith SR, Greenberg A, et al. Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med. 2013 Oct;126(10 suppl 1):S1-42.
https://www.amjmed.com/article/S0002-9343(13)00605-0/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/24074529?tool=bestpractice.com
The prevalence of mild hyponatraemia in people aged 75 years or older is around 16%.[8]Boyer S, Gayot C, Bimou C, et al. Prevalence of mild hyponatremia and its association with falls in older adults admitted to an emergency geriatric medicine unit (the MUPA unit). BMC Geriatr. 2019 Oct 15;19(1):265.
https://pmc.ncbi.nlm.nih.gov/articles/PMC6792197
http://www.ncbi.nlm.nih.gov/pubmed/31615437?tool=bestpractice.com
The incidence/prevalence of SIADH in particular is studied less thoroughly in the literature. SIADH was the most common cause of hyponatraemia in patients with cancer, accounting for around 30% of the total hyponatraemia cases.[6]Verbalis JG, Adler S, Schrier RW, et al. Efficacy and safety of oral tolvaptan therapy in patients with the syndrome of inappropriate antidiuretic hormone secretion. Eur J Endocrinol. 2011 May;164(5):725-32.
https://www.doi.org/10.1530/EJE-10-1078
http://www.ncbi.nlm.nih.gov/pubmed/21317283?tool=bestpractice.com
Hyponatraemia is a well-recognised complication of neurosurgical conditions and in one study, SIADH was the underlying pathophysiology in 62% of cases.[9]Sherlock M, O'Sullivan E, Agha A, et al. Incidence and pathophysiology of severe hyponatraemia in neurosurgical patients. Postgrad Med J. 2009 Apr;85(1002):171-5.
https://www.doi.org/10.1136/pgmj.2008.072819
http://www.ncbi.nlm.nih.gov/pubmed/19417163?tool=bestpractice.com
In another study of older patients in hospital who had hyponatraemia, almost 25% of cases met the diagnostic criteria of SIADH.[10]Zhang X, Li XY. Prevalence of hyponatremia among older inpatients in a general hospital. Eur Geriatr Med. 2020 Aug;11(4):685-692.
https://www.doi.org/10.1007/s41999-020-00320-3
http://www.ncbi.nlm.nih.gov/pubmed/32372184?tool=bestpractice.com
The most common causes of SIADH were respiratory diseases (59%), followed by malignant tumours (29%), and central nervous system diseases (10%).[10]Zhang X, Li XY. Prevalence of hyponatremia among older inpatients in a general hospital. Eur Geriatr Med. 2020 Aug;11(4):685-692.
https://www.doi.org/10.1007/s41999-020-00320-3
http://www.ncbi.nlm.nih.gov/pubmed/32372184?tool=bestpractice.com