Complexity of differentiating cerebral/renal salt wasting from SIADH: Emerging importance of determining fractional urate excretion

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Complexity of Differentiating Cerebral-Renal Salt Wasting from SIADH, Emerging Importance of Determining Fractional Urate Excretion

The current approach to the diagnosis and treatment of hyponatremia is in a state of flux, largely because of an unresolved controversy regarding the relative prevalence of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and cerebral salt wasting, or preferably renal salt wasting (RSW). The recent awareness that symptoms are now being attributed to even mild hyponatremia...

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Cerebral salt wasting versus SIADH: what difference?

The term cerebral salt wasting (CSW) was introduced before the syndrome of inappropriate antidiuretic hormone secretion was described in 1957. Subsequently, CSW virtually vanished, only to reappear a quarter century later in the neurosurgical literature. A valid diagnosis of CSW requires evidence of inappropriate urinary salt losses and reduced "effective arterial blood volume." With no gold st...

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Differentiating SIADH from Cerebral/Renal Salt Wasting: Failure of the Volume Approach and Need for a New Approach to Hyponatremia

Hyponatremia is the most common electrolyte abnormality. Its diagnostic and therapeutic approaches are in a state of flux. It is evident that hyponatremic patients are symptomatic with a potential for serious consequences at sodium levels that were once considered trivial. The recommendation to treat virtually all hyponatremics exposes the need to resolve the diagnostic and therapeutic dilemma ...

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Fractional excretion of sodium and fractional excretion of urea in differentiating prerenal from renal azotemia complicating circulatory shock

Methods Both serum FENa & FEurea were measured in 40 patients (pts) with acute kidney injury (AKI) complicating circulatory shock during their stay in ICU. All patients were divided into 26 pts (mean: 60.0 ± 15.15 years) with prerenal azotemia (group-1) and 14 pts (mean: 56.29 ± 19.5 years) with renal azotemia (group-2). Group-1 was subdivided into 12 pts (group-1a) who didn’t receive diuretics...

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Normal fractional urate excretion identifies hyponatremic patients with reset osmostat.

BACKGROUND Reset osmostat (RO) occurs in 36% of patients with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and is not often considered when evaluating hyponatremic patients. Patients with RO are not usually treated, but recent awareness that symptoms are associated with mild hyponatremia creates a therapeutic dilemma. We encountered patients with hyponatremia, hypouricemia a...

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ژورنال

عنوان ژورنال: Journal of Nephrology & Therapeutics

سال: 2012

ISSN: 2161-0959

DOI: 10.4172/2161-0959.s1.001