Reset osmostat

Introduction: Reset osmostat (RO) is a common syndrome, making up about 30 % of patients with hyponatremia. Objective: Conduct a comprehensive review of osmostat reset, describing its clinical, pathophy siologic, diagnostic, and therapeutic aspects. Methodology: A narrative review was conducted base...

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Autores:: Avallay, Flavia Paola
Musso Enz, Victoria Paula
Aroca-Martinez, Gustavo
Musso, Carlos

Tipo de recurso:

Fecha de publicación:: 2025

Institución:: Universidad Simón Bolívar

Repositorio:: Repositorio Digital USB

Idioma:: eng

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dc.title.eng.fl_str_mv	Reset osmostat
title	Reset osmostat
spellingShingle	Reset osmostat Hiponatremia Reset del osmostato Diagnóstico Concentración osmolar Vasopresinas Enfermedades transmisibles Hyponatremia Reset osmostat Diagnosis Osmolar concentration Vasopressins Communicable diseases
title_short	Reset osmostat
title_full	Reset osmostat
title_fullStr	Reset osmostat
title_full_unstemmed	Reset osmostat
title_sort	Reset osmostat
dc.creator.fl_str_mv	Avallay, Flavia Paola Musso Enz, Victoria Paula Aroca-Martinez, Gustavo Musso, Carlos
dc.contributor.author.none.fl_str_mv	Avallay, Flavia Paola Musso Enz, Victoria Paula Aroca-Martinez, Gustavo Musso, Carlos
dc.subject.spa.fl_str_mv	Hiponatremia Reset del osmostato Diagnóstico Concentración osmolar Vasopresinas Enfermedades transmisibles
topic	Hiponatremia Reset del osmostato Diagnóstico Concentración osmolar Vasopresinas Enfermedades transmisibles Hyponatremia Reset osmostat Diagnosis Osmolar concentration Vasopressins Communicable diseases
dc.subject.keywords.eng.fl_str_mv	Hyponatremia Reset osmostat Diagnosis Osmolar concentration Vasopressins Communicable diseases
description	Introduction: Reset osmostat (RO) is a common syndrome, making up about 30 % of patients with hyponatremia. Objective: Conduct a comprehensive review of osmostat reset, describing its clinical, pathophy siologic, diagnostic, and therapeutic aspects. Methodology: A narrative review was conducted based on the main articles published in the medical literature. Results: Reset osmostat has a low plasma osmolality threshold, which consequently leads to an elevation in antidiuretic hormone at a lower plasma osmolarity, along with normal water load excretion and intact urine diluting ability, while maintaining normal sodium balance. Reset osmostat can be observed in pregnancy, older age, quadriplegia, psychosis, cerebral hemorrhage, encephalitis, dementia, alcoholism, malnutrition, malignancy, and particular infectious diseases. Conclusions: Reset osmostat often resets to normal if it is the consequence of a reversible cli nical setting; however, this normalization might not happen if it is secondary to an irreversible condition. In such cases, treatment is required similar to that of any hyponatremia in order to avoid its negative consequences.
publishDate	2025
dc.date.accessioned.none.fl_str_mv	2025-06-09T22:22:25Z
dc.date.available.none.fl_str_mv	2025-06-09T22:22:25Z
dc.date.issued.none.fl_str_mv	2025
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dc.type.spa.none.fl_str_mv	Artículo científico
dc.identifier.citation.none.fl_str_mv	Avallay FP, Musso-Enz VP, Aroca-Martinez G, Musso CG. Reset osmostat. Rev.Colomb. Nefrol. 2025;12(2), e784. https://doi.org/10.22265/acnef.12.2.784
dc.identifier.issn.none.fl_str_mv	25005006 (Electrónico) 23897708 (Impreso)
dc.identifier.uri.none.fl_str_mv	https://hdl.handle.net/20.500.12442/16658
dc.identifier.doi.none.fl_str_mv	http://doi.org/10.22265/acnef.12.2.784
dc.identifier.url.none.fl_str_mv	https://revistanefrologia.org/index.php/rcn/article/view/784
identifier_str_mv	Avallay FP, Musso-Enz VP, Aroca-Martinez G, Musso CG. Reset osmostat. Rev.Colomb. Nefrol. 2025;12(2), e784. https://doi.org/10.22265/acnef.12.2.784 25005006 (Electrónico) 23897708 (Impreso)
url	https://hdl.handle.net/20.500.12442/16658 http://doi.org/10.22265/acnef.12.2.784 https://revistanefrologia.org/index.php/rcn/article/view/784
dc.language.iso.none.fl_str_mv	eng
language	eng
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dc.publisher.spa.fl_str_mv	Asociación Colombiana de Nefrología e Hipertensión Arterial
dc.source.spa.fl_str_mv	Revista Colombiana de Nefrología Vol. 12 No. 2, (2025)
dc.source.eng.fl_str_mv	Rev. Colomb. Nefrol.
institution	Universidad Simón Bolívar
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spelling	Avallay, Flavia Paolaba81ceb8-7e53-43b8-9ef4-fbc604757e80600Musso Enz, Victoria Paula1853dea4-b00c-43f7-82eb-029dbca0ed15600Aroca-Martinez, Gustavo16e964e1-2203-421e-a5b2-0a09e6363797600Musso, Carlosc14c4bc7-b52c-452b-8b57-980d8b521e576002025-06-09T22:22:25Z2025-06-09T22:22:25Z2025Avallay FP, Musso-Enz VP, Aroca-Martinez G, Musso CG. Reset osmostat. Rev.Colomb. Nefrol. 2025;12(2), e784. https://doi.org/10.22265/acnef.12.2.78425005006 (Electrónico)23897708 (Impreso)https://hdl.handle.net/20.500.12442/16658http://doi.org/10.22265/acnef.12.2.784https://revistanefrologia.org/index.php/rcn/article/view/784Introduction: Reset osmostat (RO) is a common syndrome, making up about 30 % of patients with hyponatremia. Objective: Conduct a comprehensive review of osmostat reset, describing its clinical, pathophy siologic, diagnostic, and therapeutic aspects. Methodology: A narrative review was conducted based on the main articles published in the medical literature. Results: Reset osmostat has a low plasma osmolality threshold, which consequently leads to an elevation in antidiuretic hormone at a lower plasma osmolarity, along with normal water load excretion and intact urine diluting ability, while maintaining normal sodium balance. Reset osmostat can be observed in pregnancy, older age, quadriplegia, psychosis, cerebral hemorrhage, encephalitis, dementia, alcoholism, malnutrition, malignancy, and particular infectious diseases. Conclusions: Reset osmostat often resets to normal if it is the consequence of a reversible cli nical setting; however, this normalization might not happen if it is secondary to an irreversible condition. In such cases, treatment is required similar to that of any hyponatremia in order to avoid its negative consequences.Introducción: el reset del osmostato (RO) es un síndrome común que representa aproximadamente el 30 % de los pacientes con hiponatremia. Objetivo: realizar una revisión exhaustiva sobre el reset del osmostato, describiendo sus aspectos clínicos, fisiopatológicos, diagnósticos y terapéuticos. Metodología: se realizó una revisión narrativa basada en los principales artículos publicados en la literatura médica. Resultados: el reset del osmostato tiene un umbral de osmolalidad plasmática bajo que, en consecuen cia, conduce a una elevación de la hormona antidiurética y a una osmolaridad plasmática más baja, junto con una capacidad intacta para diluir la orina y mantener el equilibrio normal de sodio. El reset del osmostato se puede observar en el embarazo, la vejez, la cuadriplejía, la psicosis, la hemorragia cerebral, la encefalitis, la demencia, el alcoholismo, la desnutrición, las enfermedades malignas y en determinadas enfermedades infecciosas. Conclusión: el reset del osmostato a menudo se restablece a la normalidad si ha sido inducido por una enfermedad reversible; sin embargo, puede no normalizarse si lo induce una condición irreversible. En tales casos, se requiere un tratamiento similar al de cualquier hiponatremia para evitar sus consecuencias negativas.pdfengAsociación Colombiana de Nefrología e Hipertensión ArterialAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Revista Colombiana de NefrologíaVol. 12 No. 2, (2025)Rev. Colomb. Nefrol.HiponatremiaReset del osmostatoDiagnósticoConcentración osmolarVasopresinasEnfermedades transmisiblesHyponatremiaReset osmostatDiagnosisOsmolar concentrationVasopressinsCommunicable diseasesReset osmostatinfo:eu-repo/semantics/articleArtículo científicohttp://purl.org/coar/version/c_970fb48d4fbd8a85http://purl.org/coar/resource_type/c_2df8fbb1Esposito P, Piotti G, Bianzina S, Malul Y, Dal-Canton A. The syndrome of inappropriate antidiuresis: Pathophysiology, clinical management and new therapeutic options. Nephron Clin Pract. 2011;119(1):c62–c73. https://doi.org/10.1159/000324653Robertson GL. Regulation of arginine vasopressin in the syndrome of inappropriate an tidiuresis. Am J Prev. 2006;119(7):S36-S42. https://doi.org/10.1016/j.amjmed.2006.05.006Moritz M. Syndrome of inappropriate antidiuresis and cerebral salt wasting syndrome: Are they different and does it matter? Pediatr Nephrol. 2012;27(5):689-93. https://doi.org/10.1007/ s00467-012-2112-1Maesaka J, Imbriano L. Cerebral salt wasting is a real cause of hyponatremia: PRO. Kid ney360. 2022;4(4):e437-e440. https://doi.org/10.Sterns R, Rondon-Berrios H. Cerebral salt wasting is a real cause of hyponatremia: CON. Kidney360. 2022;4(4):e441-e444. https://doi.org/10.34067/KID.0001412022Palmer B, Clegg D. Cerebral salt wasting is a real cause of hyponatremia: COMMENTARY. Kidney360. 2022;4(4):e445-e447. https://doi.org/10.34067/KID.0001452022Bitew S, Imbriano L, Miyawaki N, Fishbane S, Maesaka JK. More on renal salt wasting without cerebral disease: Response to saline infusion. Clin J Am Soc Nephrol. 2009;4(2):309- 315. https://doi.org/10.2215/CJN.02740608Harris K, Shankar R, Black K, Rochelson B. Reset osmostat in pregnancy: A case re port. J Matern Fetal Neonatal Med. 2014;27(5):530-553. https://doi.org/10.3109/14767058.2013. 819333Rohana AG, Norasyikin AW, Suehazlyn Z, Ming W, Norlela S, Norazmi MK. A case of persistent hyponatraemia due to reset osmostat. Med J Malaysia. 2006;61(5):638-640.Liamis GL, Milionis HJ, Rizos EC, Siamopoulos KC, Elisaf MS. Mechanisms of hyponatrae mia in alcohol patients. Alcohol Alcohol. 2000;35(6):612-616. https://doi.org/10.1093/alcalc/ 35.6.612Imbriano LJ, Mattana J, Drakakis J, Maesaka JK. Identifying different causes of hyponatre mia with fractional excretion of uric acid. Am J Med Sci. 2016;352(4):385-390. https://doi.org/ 10.1016/j.amjms.2016.05.035Hoorn EJ, Swart RM, Westerink M, van den Dorpel MA, Berghout A, Bakker JJ. Hypona tremia due to reset osmostat in dementia with lewy bodies. J Am Geriatr Soc. 2008;56(3):567- 569. https://doi.org/10.1111/j.1532-5415.2008.01579.xVale BM, Morais S, Mesquita J, Mimoso G. Reset osmostat: A rare cause of hyponatraemia. BMJ Case Rep. 2015;2015:bcr2013009111. https://doi.org/10.1136/bcr-2013-009111Suneja M, Makki N, Kuppachi S. Essential hypernatremia: Evidence of reset osmostat in the absence of demonstrable hypothalamic lesions. Am J Med Sci. 2014;347(4):341-342. https://doi.org/10.1097/MAJ.0000000000000246Feder J, Gomez JM, Serra-Aguirre F, Musso CG. Reset osmostat: Facts and controversies. Indian J Nephrol. 2019;29(4):232-234. https://doi.org/10.4103/ijn.IJN 307 17Harris K, Shankar R, Black K, Rochelson B. Reset osmostat in pregnancy: A case report. J Matern Fetal Neonatal Med. 2014;27(5):530-533. https://doi.org/10.3109/14767058.2013. 819333 ↑Musso CG, Jauregui JR. Hyponatremia secondary to reset osmostat in a very old individual: A case report and pathophysiologic proposal. Electron J Biomed. 2016;3: 49-51.Rigueto LG, Santiago HM, Hadad DJ, Seguro AS, Girardi ACC, Luchi WM. The “new normal” osmotic threshold: Osmostat reset. Clin Nephrol Case Studies. 2022; 10(1):11-15. https://doi.org/10.5414/CNCS110740Imbriano LJ, Ilamathi E, Ali NM, Miyawaki N, Maesaka JK. Normal fractional urate excretion identifies hyponatremic patients with reset osmostat. J Nephrol. 2012;25(5):833-838. https://doi.org/10.5301/jn.5000074Maesaka JK, Imbriano LJ, Miyawaki N. High prevalence of renal salt wasting without cerebral disease as cause of hyponatremia in general medical ward. Am J Med Sci. 2018;356(1):15-22. https://doi.org/10.1016/j.amjms.2018.03.020Hoorn EJ, Zietse R. Diagnosis and treatment of hyponatremia: Compilation of the guidelines. J Am Soc Nephrol. 2017;28(5):1340-1349. https://doi.org/10.1681/ASN.2016101139Musso CG, Vilas M. Water, electrolyte, and acid-base disorders in the elderly. In: Macias Nunez JF, Jauregui J, Covic A, Musso CG, editors. Clinical Nephrogeriatrics. Springer Cham. 2019. p.43-62. https://doi.org/10.1007/978-3-030-18711-8 4Assadi F and Mazaheri M. Differentiating syndrome of inappropriate ADH, reset osmos tat, cerebral/renal salt wasting using fractional urate excretion. J Pediatr Endocrinol Metab. 2021;34(1):137–140. https://doi.org/10.1515/jpem-2020-0379Kuthiah N, Er C. Reset osmostat: A challenging case of hyponatremia. Case Rep Med. 2018;2018:5670671. https://doi.org/10.1155/2018/5670671Berl T, Schrier R. Water homeostasis alterations. In: Schrier R (Editor). Renal and Elec trolytes Alterations. Philadelphia. Lippincott Williams & Wilkins. 2011. p.1-85Decaux G. Is asymptomatic hyponatremia really asymptomatic? Am J Med. 2006;119(7):S79-82. https://doi.org/10.1016/j.amjmed.2006.05.013Lee JJ, Kilonzo K, Nistico A, Yeates K. Management of hyponatremia. CMAJ. 2014;186(8):E281-E286. https://doi.org/10.1503/cmaj.120887Renneboog B, Musch W, Vandemergel X, Manto M, Decaux G. Mild chronic hyponatremia is associated with falls, unsteadiness, and attention deficits. Am J Med 2006;119(1):711-718. https://doi.org/10.1016/j.amjmed.2005.09.026Gankam Kengne F, Andres C, Sattar L, Melot C, Decaux G. Mild hyponatremia and risk of fracture in the ambulatory elderly. QJM-INT J Med J. 2008;101(7):583–8. https://doi.org/ 10.1093/qjmed/hcn061Decaux G. Morbidity associated with chronic hyponatremia. J Clin Med. 2023;12(3):978. https://doi.org/10.3390/jcm12030978Verbalis JG, Barsony J, Sugimura Y, Tian Y, Adams DJ, Carter EA, et al. Hyponatremia induced osteoporosis. JBMR. 2010;25(3):554-563. https://doi.org/10.1359/jbmr.090827Ayus JC, Tejedor A, Caramelo C. Agua, electrolitos y equilibrio ácido-base. 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Reset osmostat

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