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OBJECTIVE: To determine the prevalence of syndrome of inappropriate antidiuretic hormone secretion (SIADH) among older hyponatremic patients in a subacute geriatric facility, to identify patients with no apparent cause for the SIADH (idiopathic SIADH), and to determine their clinical characteristics.
The following investigations could be carried out in SIADH. 1  urea and electrolytes. 2  plasma and urine osmolality. 3  urinary sodium. 4  thyroid function tests. 5  a short synacthen test (1) 6  chest and skull radiographs may be useful in excluding other causes of SIADH. Note: it is important to exclude diuretic use (especially thiazides), hypothyroidism and adrenal insufficiency before the diagnosis of SIADH is made (3)