The Utility of copeptin as a predictor for post operative hyponatremia and hypernatremia in endoscopic pituitary adenoma surgery patients

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Arginine vasopressin (AVP) is an important hormone responsible for maintaining sodium homeostasis after pituitary surgery. The measurement of AVP levels is difficult because of its short half-life (t1/2). Copeptin is a preprohormone of AVP, and it is a more stable peptide, which can be used as surrogate marker for AVP. This study aims to assess the role of copeptin as a predictor of postoperative hyponatremia and hypernatremia in patients undergoing endoscopic pituitary adenoma surgery. In this prospective study of patients who underwent endoscopic pituitary adenoma surgery, Serum copeptin levels were assessed preoperatively (C1), at extubation (C2), and postoperative day 4 (C3). A relative increase or decrease in early change in copeptin (C2-C1) can predict development of early hyponatremia or transient central diabetes insipidus, respectively. A relative increase in delayed change in copeptin (C3- C1) can predict development of delayed hyponatremia. Acknowledgement : Anand Binu, MCh, Easwer HV, MCh, Prakash Nair1, MCh, Antony Stanley, MD, Biren Khimji Patel, MCh, Madhusoodanan Urulangodi2, PhD, Geetha Mandagini, PhD( 1=Department of Neurosurgery, 2= Department of Biochemistry)