An Integrative Review of Cerebral Salt Wasting Syndrome

Abstract

BACKGROUND: Although cerebral salt wasting syndrome (CSWS) is widely recognized, its clinical characteristics, diagnostic criteria, and management have not been clearly defined. This study was undertaken to comprehensively review current literature and provide a more complete picture of CSWS. This review also aimed to provide information for nurses on how to differentiate cerebral salt wasting syndrome from syndrome of inappropriate antidiuretic hormone secretion. METHODS: An integrative review was performed. Searches were conducted between May and July 2018. The primary information sources were CINAHL, Google Scholar, MEDLINE, PubMed, Scopus, and Web of Science. Included articles were published from 1954 to July 2018. RESULTS: The essential features of CSWS are hyponatremia, hypovolemia, and increased urine output. Treatment regimens may be determined based on the acuity and severity of hyponatremia and hypovolemia as well as evident symptoms and signs. CONCLUSION: This review may help neuroscience nurses become knowledgeable about CSWS for the drafting of appropriate nursing care plans and also be able to differentiate CSWS from syndrome of inappropriate antidiuretic hormone secretion as early as possible for timely and proper management.

Hyperlactatemia and other perioperative metabolic disturbances in neuroanesthesia

“…The reported incidence of CSWS in patients with intracranial pathology reflects its vague definition and varies between 0 and 94% [ 12 ]. Some authors describe an association between the incidence of CSWS and the severity of the intracranial pathology (assessed by computed tomography-scan or Glasgow Coma Score (GCS)), but this is debated [ 13 ]. Although the pathophysiology of SIADH is clearly defined by its name, the involved mechanisms in CSWS are less clear.…”

“…Although the pathophysiology of SIADH is clearly defined by its name, the involved mechanisms in CSWS are less clear. At least five natriuretic peptides have been identified to be associated with CSWS: atrial natriuretic peptide, brain natriuretic peptide, C-type natriuretic peptide, dendroaspis natriuretic peptide, and ouabainlike peptide [ 13 ]. Furthermore, a reduction of the sympathetic input to the kidneys seems to play another important role in CSWS.…”

“…The latter further inhibits sodium retention and can be present without intracranial pathology. In that case the term ‘renal salt wasting syndrome’ (RSWS) is used [ 13 ].…”

Hyponatremia in Young Patients with Pulmonary Tuberculosis and Tuberculous Meningoencephalitis

“…The exact cause is not fully understood, but it is believed to be associated with hypoxia, hypovolemia, or reduced blood volume. On the other hand, CSWS leads to hyponatremia and decrease extracellular fluid volume due to renal salt depletion (Oh & Seo, 2020). SIADH physiologically involves inappropriate ADH secretion or increased renal sensitivity to ADH, resulting in kidney water retention and euvolemic hyponatremia hyponatremia (Ye et al, 2022).…”