Salt-Losing Nephritis Simulating Adrenocortical Insufficiency

Sawyer, Wilbur H.; Solez, Chester

doi:10.1056/nejm194902102400603

Cited by 40 publications

(5 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has been reported in glomerulonephritis (Thorn et al, 1944;Sawyer and Solez, 1949;Murphy, Settimi and Kozokoff, 1953), pyelonephritis (Joiner and Thorne, 1952;Enticknap, 1952;Nussbaum, Bernhard and Mattia, 1952), polycystic kidney disease (Borst, 1949), nephrocalcinosis, analgesic nephropathy (Cove-Smith and Knapp, 1973) and renal tract obstruction (Morgan et al, 1978). Although this is apparently a non-specific pathological change, it seems to occur more commonly in tubular than in glomerular disorders (Kleeman, Okun and Heller, 1966).…”

Section: Discussionmentioning

confidence: 99%

Obstructive sodium-losing nephropathy--a case report and review

Nunn

Owens

Scholberg

et al. 1981

Postgraduate Medical Journal

View full text Add to dashboard Cite

Summary The third case in the literature of sodium-losing renal disease due to obstruction is presented. The experimental evidence and limited clinical experience is reviewed which suggests that the sodium loss is due to an inappropriate response in the adaptive processes that are initiated by the loss of functioning nephrons. The immediate treatment is by replacement of sodium but in the long term the condition may be reversed by very cautious reduction in sodium intake. Definitive treatment may be indicated where obstruction is the cause and consequently this should be sought in all cases of salt-losing renal disease.

show abstract

Section: Discussionmentioning

confidence: 99%

Obstructive sodium-losing nephropathy--a case report and review

Nunn

Owens

Scholberg

et al. 1981

Postgraduate Medical Journal

View full text Add to dashboard Cite

show abstract

“…The relatively high efficiency of the sodium cycle resin in augmenting the stool output of potassium suggests its possible application in renal insufficiency of the salt-wastage and potassium accumulation type. This agent under such circumstances should augment the external losses of potassium and simultaneously cancel the negative balances of sodium which characterize this disorder (6)(7)(8).…”

Section: Discussionmentioning

confidence: 99%

Biochemical Changes Accompanying the Ingestion of a Carboxylic Cation Exchanger in the Hydrogen, Ammonium, Sodium, Potassium, or Calcium Form

Greenman¹,

Peters²,

Mateer³

et al. 1951

J. Clin. Invest.

View full text Add to dashboard Cite

“…58 Later, the term salt wasting nephritis was proposed to characterize a minority of patients with CKD who lose large amounts of NaCl in their urine. 59 The majority of patients with CKD have only a modest tendency to waste salt, as indicated by the fact that they cannot reduce urinary NaCl excretion promptly during dietary salt restriction. Despite this, they often have ECF volume expansion, when consuming a ‘Western’ diet, as discussed above.…”

Section: Salt Wasting In Ckdmentioning

confidence: 99%

“…This mechanism is probably most prominent when massive salt wasting (see below) results from tubulointerstitial or medullary cystic disease and can resemble Addison’s disease. 59 According to Bricker and colleagues, 9 many cases of salt wasting associated with CKD are reversible, if the dietary salt deprivation is imposed gradually. This type of salt-wasting tendency likely contributes to the predisposition to AKI in patients with CKD.…”

Section: Salt Wasting In Ckdmentioning

confidence: 99%

Treatment of Disorders of Sodium Balance in Chronic Kidney Disease

Ellison

2017

Advances in Chronic Kidney Disease

View full text Add to dashboard Cite

Extracellular fluid volume expansion is nearly universal in patients with chronic kidney disease. Such volume expansion often overlaps with the syndrome of heart failure with preserved ejection fraction, which can not only lead to symptoms, but can also lead to further organ damage. Unique treatment challenges are present in this patient population, including low glomerular filtration, which limits sodium chloride filtration, intrinsic tubule predisposition to sodium chloride retention, and proteinuria. Additionally, pharmacokinetic considerations alter the disposition of diuretics in patients with chronic kidney disease and nephrotic syndrome. Maintaining extracellular fluid volume near to normal is often necessary for hypertension treatment in this population, but it may also help prevent progressive cardiovascular and renal damage. Although powerful diuretics can often accomplish this goal, this often comes at a cost of competing side effects. An approach to reduce extracellular fluid volume while avoiding side effects, therefore, requires a nuanced yet aggressive therapeutic approach.

show abstract

Salt-Losing Nephritis Simulating Adrenocortical Insufficiency

Cited by 40 publications

References 15 publications

Obstructive sodium-losing nephropathy--a case report and review

Obstructive sodium-losing nephropathy--a case report and review

Biochemical Changes Accompanying the Ingestion of a Carboxylic Cation Exchanger in the Hydrogen, Ammonium, Sodium, Potassium, or Calcium Form

Treatment of Disorders of Sodium Balance in Chronic Kidney Disease

Contact Info

Product

Resources

About