Sodium and water regulation in a patient with cerebral salt wasting. Arch Neurol 1989 Aug;46(8):928-30
Date
08/01/1989Pubmed ID
2757534DOI
10.1001/archneur.1989.00520440124031Scopus ID
2-s2.0-0024315539 (requires institutional sign-in at Scopus site) 46 CitationsAbstract
Hyponatremia, in patients with central nervous system disease, can be attributable to impaired free water excretion (syndrome of inappropriate secretion of antidiuretic hormone) or to excessive sodium excretion (cerebral salt wasting). We present a patient with a parietal glioma and hyponatremia characterized by salt wasting and dehydration. Rehydration and sodium repletion corrected the sodium and volume deficits; withdrawal of supplemental sodium resulted in recurrence of dehydration and hyponatremia. We determined sodium and water balance and measured plasma atriopeptin, antidiuretic hormone, and aldosterone. Plasma atriopeptin ranged from 8 to 44 pg/mL (normal, less than 45 pg/mL); antidiuretic hormone was not elevated at 4 to 5 pg/mL, and aldosterone was slightly elevated at 1040.25 pmol/L. The concentrations of these hormones could not directly explain the natriuresis; interactions with neural or other humoral factors may be involved. In evaluating such patients, careful attention to sodium and water balance is important to guide appropriate therapy.
Author List
Diringer M, Ladenson PW, Borel C, Hart GK, Kirsch JR, Hanley DFMESH terms used to index this publication - Major topics in bold
AdultAldosterone
Brain Neoplasms
Dehydration
Glioma
Humans
Hyponatremia
Male
Sodium
Vasopressins
Water-Electrolyte Balance