UreaAide

KidneyAide  The so called tea and toast Hyponatremia has always fascinated us.  The kidney can not expel water without solute (stuff like Urea, Salt, and Potassium).  The classic presentation of this is an elder female who is eating very little but continues to drink plenty of liquids. As we age our ability to dilute the urine becomes impaired1.  If, for example, one can only dilute the urine to 200 mosm/L and they are drinking 2.5 liters/day of liquids, with only 300 mosm of solute/day, this will start to dilute the serum sodium level.  With the example above the first liter of liquid will go out with the first 200 mosm of solute.  Now we have 1.5 liters still to get rid of and only 100 mosm to do it. Another 500 cc out with the last 100 mosm.  Now what?  We are left with 1 liter of liquid.  Insensible losses will help, that is sweat, feces and respirations.  In fact in this scenario those losses may equal 1 liter and we could break even for the day. If this same person, however, dran

 Urea’s Greatness in SIADH Hyponatremia. Urea with an atomic mass of ~60 g/mol is a wonderful medication to help rid the body of excess water, and thus improve serum sodium levels.  Typically in SIADH the urine osm, or solute (solute=stuff besides water) is fixed around 500 osm/L. This is terribly ineffective at excreting water, and thus over days the body’s sodium becomes diluted.  Fluid restriction alone is almost never enough.  Salt pills taste terrible and cause edema and elevated blood pressure.  Tolvaptan works ok but at a cost of $300/dose and a 5% risk of liver toxicity, this is less then ideal.  Therefore the best way to treat SIADH is Urea.  A typical starting dose of 30 grams/day (in 2 divided doses) offers up the kidney 500 osm of solute ready to excrete that excess water.  This will raise the sodium back up by causing an osmotic aquaresis. It would take nearly 25 salt tablets a day to achieve this!  UreaAide, a novel American formulation made by KidneyAide.com is the obvio