How can you tell the difference between SIADH and cerebral salt wasting?
However, urinary sodium excretion (urinary sodium concentration [mEq/L] x urinary volume [L/24 h]) is substantially higher than sodium intake in cerebral salt-wasting syndrome but generally equals sodium intake in SIADH. Therefore, net sodium balance (intake minus output) is negative in cerebral salt-wasting syndrome.
How can you tell the difference between CSW and SIADH?
Levels of natriuretic peptides and changes in fractional excretion of uric acid may help differentiate between the two conditions. The key difference is that SIADH is a euvolemic to mildly hypervolumic state, whereas CSW is a volume-depleted state.
What causes salt wasting?
The exact mechanism underlying cerebral salt-wasting syndrome remains unclear. In the setting of cerebral injury, one hypothesis is that an exaggerated renal pressure–natriuresis response caused by increased activity of the sympathetic nervous system and dopamine release is responsible for urinary sodium loss.
What does salt wasting mean?
Cerebral salt wasting (CSW) is defined as excessive urinary sodium and subsequent hyponatremia and dehydration in individuals with intracranial disease. The mechanism is not clear. CSW typically develops in the first week after brain injury and generally resolves over time.
Is urine sodium low in SIADH?
With SIADH (and salt-wasting syndrome), the urine sodium is greater than 20-40 mEq/L. With hypovolemia, the urine sodium typically measures less than 25 mEq/L. However, if sodium intake in a patient with SIADH (or salt-wasting) happens to be low, then urine sodium may fall below 25 mEq/L.
What is salt wasting disease?
Cerebral salt wasting syndrome (CSW) is defined as a renal loss of sodium during intracranial disease leading to hyponatremia and a decrease in extracellular fluid volume. The pathogenesis of this disorder is still not completely understood.
What is salt losing nephropathy?
Salt-losing nephropathy may be defined as a clinical syndrome with all of the following. characteristics: (a) The development of severe volume and sodium depletion caused by renal salt. wasting. Renal salt wasting is documented either by demonstrating a urinary sodium excretion.
What are the symptoms of salt wasting?
Salt-wasting CAH
- Dehydration.
- Poor feeding.
- Diarrhea.
- Vomiting.
- Heart rhythm problems (arrhythmias)
- Low blood pressure.
- Very low blood sodium levels.
- Low blood glucose.
What is salt wasting congenital adrenal hyperplasia?
Salt-wasting CAH is the severe form of classic 21-hydroxylase deficiency. In this type of CAH, the adrenal glands make too little aldosterone, causing the body to be unable to retain enough sodium (salt). Too much sodium is lost in urine (thus the name, “salt-wasting”).