Neurológia pre prax 3/2014

CSWS and SIADH associated with CNS disease

Disorder of water and sodium balance with no obvious associated disease of other internal organs can sometimes be encountered in a patient with a neurological disease. In neurological disease, such disorders result from centrally mediated dysregulation of water and sodium excretion by the kidneys with the development of hypoosmolar hyponatremia. Cerebral salt-wasting syndrome (CSWS) and the syndrome of inappropriate antidiuretic hormone secretion (SIADH) are the most common causes of this disorder. In prognostic terms, it is very important to identify and appropriately treat these two entities. Negative salt balance, hypovolemia, and good therapeutic response to replacement of lost fluid and salt are indicative of the presence of CSWS; by contrast, patients with SIADH are hyper- or euvolemic and restricted fluid intake is the mainstay of therapy.

Keywords: CSWS, SIADH, hypoosmolar hypovolemic hyponatremia, hypoosmolar hypervolemic hyponatremia.