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Primary Polydipsia in the Medical and Psychiatric Patients

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Primary Polydipsia in the Medical and Psychiatric Patients Primary polydipsia in the medical and psychiatric patients Inaugural dissertation To be awarded the degree of Dr sc. med. presented at the Faculty of Medicine of the University of Basel by Dr med. Clara Odilia Sailer from Volmarstein, Germany / Brittnau, Switzerland Basel, 2020 Originaldokument gespeichert auf dem Dokumentenserver der Universität Basel edoc.unibas.ch Approved by the Faculty of Medicine On application of Professor Dr med. Mirjam Christ-Crain (first supervisor) Professor Dr med. Stefan Borgwardt (second supervisor) Professor Dr med. Ewout Hoorn (external expert) Basel, ..................................... …................................................ Dean Professor Dr med. Primo Schär Inaugural dissertation – Dr med. Clara Odilia Sailer 2 Table of contents TABLE OF CONTENTS ...................................................................................................................................... 3 SUMMARY OF THE PROJECT ........................................................................................................................... 5 ACKNOWLEDGMENTS .................................................................................................................................... 6 INTRODUCTION .............................................................................................................................................. 8 MAIN OBJECTIVES OF THIS MD-PHD ......................................................................................................................... 12 CONTRIBUTION BY THE MD-PHD STUDENT ................................................................................................................ 13 REVIEW: PRIMARY POLYDIPSIA IN THE MEDICAL AND PSYCHIATRIC PATIENT: CHARACTERISTICS, COMPLICATIONS AND THERAPY ................................................................................................................... 15 ABSTRACT ............................................................................................................................................................ 16 INTRODUCTION ..................................................................................................................................................... 17 PATHOPHYSIOLOGY ................................................................................................................................................ 18 DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS OF PP ......................................................................................................... 21 COMPLICATIONS OF PP ........................................................................................................................................... 23 TREATING PRIMARY POLYDIPSIA AND ITS COMPLICATIONS .............................................................................................. 25 CONCLUSION ........................................................................................................................................................ 26 MANUSCRIPT I: CHARACTERISTICS AND OUTCOMES OF PATIENTS WITH PROFOUND HYPONATRAEMIA DUE TO PRIMARY POLYDIPSIA ............................................................................................................................. 27 ABSTRACT ............................................................................................................................................................ 28 INTRODUCTION ..................................................................................................................................................... 29 MATERIALS AND METHODS ...................................................................................................................................... 31 RESULTS .............................................................................................................................................................. 33 DISCUSSION .......................................................................................................................................................... 38 MANUSCRIPT II: INFLUENCE OF OUTDOOR TEMPERATURE AND RELATIVE HUMIDITY ON INCIDENCE AND ETIOLOGY OF HYPONATREMIA ..................................................................................................................... 42 ABSTRACT ............................................................................................................................................................ 43 INTRODUCTION ..................................................................................................................................................... 44 MATERIALS AND METHODS ...................................................................................................................................... 45 RESULTS .............................................................................................................................................................. 47 DISCUSSION .......................................................................................................................................................... 52 MANUSCRIPT III: SEASONALITY OF HYPOOSMOLAR HYPONATREMIA IN MEDICAL INPATIENTS - DATA FROM A NATIONWIDE COHORT STUDY ...................................................................................................................... 56 ABSTRACT ............................................................................................................................................................ 57 INTRODUCTION ..................................................................................................................................................... 58 Inaugural dissertation – Dr med. Clara Odilia Sailer 3 MATERIALS AND METHODS ..................................................................................................................................... 59 RESULTS .............................................................................................................................................................. 61 DISCUSSION .......................................................................................................................................................... 67 MANUSCRIPT IV: GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONISTS: NEW TREATMENT OPTION FOR PATIENTS WITH PRIMARY POLYDIPSIA? ....................................................................................................................... 70 ABSTRACT ............................................................................................................................................................ 71 INTRODUCTION ..................................................................................................................................................... 72 MATERIALS AND METHODS ...................................................................................................................................... 73 RESULTS .............................................................................................................................................................. 77 DISCUSSION .......................................................................................................................................................... 82 OTHER PUBLISHED ORIGINAL ARTICLES (FIRST AUTHOR) .............................................................................. 85 EFFECTS OF ALCOHOL CONSUMPTION ON COPEPTIN LEVELS AND SODIUM-WATER HOMEOSTASIS ............................................ 85 MILD TO MODERATE HYPONATREMIA AT DISCHARGE IS ASSOCIATED WITH INCREASED RISK OF RECURRENCE IN PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA ........................................................................................................................ 86 MARKERS OF SYSTEMIC INFLAMMATION IN RESPONSE TO OSMOTIC STIMULUS IN HEALTHY VOLUNTEERS .................................. 87 THE CHALLENGES OF SODIUM MEASUREMENTS: INDIRECT VERSUS DIRECT ION-SELECTIVE METHOD ......................................... 88 PUBLISHED ORIGINAL ARTICLES (CO-AUTHOR) ............................................................................................. 89 A RANDOMIZED TRIAL OF EMPAGLIFLOZIN TO INCREASE PLASMA SODIUM LEVELS IN PATIENTS WITH THE SYNDROME OF INAPPROPRIATE ANTIDIURESIS .................................................................................................................................. 89 ARGININE-STIMULATED COPEPTIN MEASUREMENTS IN THE DIFFERENTIAL DIAGNOSIS OF DIABETES INSIPIDUS: A PROSPECTIVE DIAGNOSTIC STUDY ................................................................................................................................................ 90 EFFECTS OF GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONISTS ON HYPOTHALAMIC-PITUITARY-ADRENAL AXIS IN HEALTHY VOLUNTEERS ........................................................................................................................................................ 92 FGF-21 LEVELS IN POLYURIA-POLYDIPSIA SYNDROME ................................................................................................... 93 DISCUSSION AND OUTLOOK ......................................................................................................................... 94 DIRECTION FOR FUTURE RESEARCH ............................................................................................................................ 97 CONCLUSION AND CLOSING REMARK
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