Hyponatremia in the cancer patient

Kidney Int. 2020 Oct;98(4):870-882. doi: 10.1016/j.kint.2020.05.015. Epub 2020 Jun 1.


Hyponatremia is a common electrolyte disorder observed in a wide variety of malignancies and is associated with substantial morbidity and mortality. Newer cancer therapies have improved patient outcomes while contributing to new cases of hyponatremia. Patients should be monitored closely for the development of vasopressin- and non-vasopressin-mediated hyponatremia. Acute and symptomatic forms of hyponatremia require urgent intervention, and recent findings support the correction of chronic "asymptomatic" hyponatremia. Optimizing hyponatremia may reduce medical costs, and improve cancer survival likelihood and quality of life. In this article, we review the epidemiology, pathophysiology, etiology, diagnosis, and treatment of hyponatremia in the cancer patient.

Keywords: adrenal insufficiency; cancer; hyponatremia; immunotherapy; inappropriate ADH syndrome; onconephrology; tolvaptan; urea.

Publication types

  • Review

MeSH terms

  • Antidiuretic Hormone Receptor Antagonists / therapeutic use
  • Benzazepines
  • Humans
  • Hyponatremia* / diagnosis
  • Hyponatremia* / epidemiology
  • Hyponatremia* / etiology
  • Inappropriate ADH Syndrome* / diagnosis
  • Inappropriate ADH Syndrome* / epidemiology
  • Inappropriate ADH Syndrome* / therapy
  • Neoplasms* / complications
  • Neoplasms* / epidemiology
  • Quality of Life
  • Tolvaptan


  • Antidiuretic Hormone Receptor Antagonists
  • Benzazepines
  • Tolvaptan