Cerebral salt wasting syndrome.
There is significant evidence to show that many patients with hyponatremia and intracranial disease who were previously diagnosed with SIADH actually have CSW. The critical difference between SIADH and CSW is that CSW involves renal salt loss leading to hyponatremia and volume loss, whereas SIADH is a euvolemic or hypervolemic condition. Attention to volume status in patients with hyponatremia is essential. The primary treatment for CSW is water and salt replacement. The mechanisms underlying CSW are not understood but may involve ANP or other natriuretic factors and direct neural influence on renal function. Future investigation is needed to better define the incidence of CSW in patients with intracranial disease, identify other disorders that can lead to CSW, and elucidate the mechanisms underlying this syndrome.
Harrigan
M R
MR
Department of Surgery, Section of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA. harrigan@umich.edu
D000818:Animals; D009320:Atrial Natriuretic Factor / Q000097:blood; D001927:Brain Diseases / Q000150:complications*; D003937:Diagnosis, Differential; D004195:Disease Models, Animal; D005440:Fluid Therapy / Q000379:methods; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D007177:Inappropriate ADH Syndrome / Q000175:diagnosis; D007674:Kidney Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy
D009320:Atrial Natriuretic Factor