What causes cerebral salt-wasting syndrome (CSWS) (renal salt wasting)?

Updated: May 13, 2020
  • Author: Sudha Garimella, MBBS; Chief Editor: Sasigarn A Bowden, MD  more...
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Cerebral salt-wasting syndrome, or renal salt wasting, occurs in the setting of acute central nervous system (CNS) disease. Conditions leading to cerebral salt-wasting syndrome include the following:

  • Head injury

  • Brain tumor

  • Intracranial surgery

  • Stroke

  • Intracerebral hemorrhage [9]

  • Tuberculous meningitis

  • Craniosynostosis repair

Cerebral salt-wasting syndrome can also occur in the absence of cerebral disease. [7]

The exact mechanism underlying cerebral salt-wasting syndrome remains unclear. In the setting of cerebral injury, one hypothesis is that an exaggerated renal pressure–natriuresis response caused by increased activity of the sympathetic nervous system and dopamine release is responsible for urinary sodium loss.

Another hypothesis involves the release of natriuretic factors, possibly including brain natriuretic peptide (C-type natriuretic peptide) or urodilatin by the injured brain. Kojima et al have described an animal model of cerebral salt-wasting syndrome that may allow better clarification of the condition’s etiology. [10]

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