Analysis of syndrome of inappropriate anti-diuresis and cerebral salt wasting in patients with acute stroke

Abstract

Hyponatremia in hospitalized patients can significantly alter the morbidity, mortality, especially in chronic neurological patients. Most commonly, it is attributed to SIADH, and in stroke it occurs due to AVP secretion inappropriate to the osmotic threshold. The suppressed proximal renal tubular transport in this condition can lead on to bicarbonaturia and hypouricemia. CSW, on the other hand, is essentially a volume depleted state, which occurs due to the combined effects of decreased sympathetic outflow and increased natriuretic peptides. This resultant natriuresis leads to volume depletion and an appropriate AVP response. The treatment for SIADH AND CSW varies, and the outcomes vary considerably too. Hence, we performed this study to study the clinical profile of stroke patients with hyponatremia, and to identify the factors associated with the same.