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Chronic hyponatremia in a patient with renal salt wasting and without cerebral disease: relationship between RSW, risk of fractures and cognitive impairment

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Abstract

Renal salt wasting syndrome (RSW) is defined as a renal loss of sodium leading to hyponatremia and a decrease in extracellular fluid volume (ECV). Differentiation of this disorder from the syndrome of inappropriate antidiuretic hormone secretion (SIADH), a common cause of hyponatremia, can be difficult because both can present with hyponatremia and concentrated urine with natriuresis. Our clinical case about a 78-year-old woman with a recent fracture of the right femur not only confirms that this syndrome can occur in patients without intracranial pathologies (CT documented), but depicts how the hyponatremia caused by RSW can show a chronic, oscillating course. This is an interesting point of view because it suggests to us to consider RSW in the differential diagnosis of patients with chronic hyponatremia.

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Authors and Affiliations

  1. U.O.C. di Medicina Interna Con Stroke Care, Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S.), University of Palermo, Palermo, Italy

    Vittoriano Della Corte, Antonino Tuttolomondo, Rosaria Pecoraro & Antonio Pinto

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  1. Vittoriano Della Corte
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  2. Antonino Tuttolomondo
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  3. Rosaria Pecoraro
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  4. Antonio Pinto
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Correspondence to Vittoriano Della Corte.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Della Corte, V., Tuttolomondo, A., Pecoraro, R. et al. Chronic hyponatremia in a patient with renal salt wasting and without cerebral disease: relationship between RSW, risk of fractures and cognitive impairment. Intern Emerg Med 13, 1167–1171 (2018). https://doi.org/10.1007/s11739-018-1926-7

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