Which physical findings are characteristic of 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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Answer

Physical signs of cerebral salt-wasting syndrome (renal salt wasting) include those associated with severe hyponatremia or intravascular volume depletion.

Hyponatremia can be indicated by acute CNS dysfunction, such as altered mental status, seizures, and coma.

The differentiation of SIADH from cerebral salt-wasting syndrome depends on an accurate estimation of extracellular volume. Unfortunately, no single physical finding can accurately and reproducibly measure effective circulating volume. Commonly used signs of hypovolemia include orthostatic tachycardia or hypotension, increased capillary refill time, increased skin turgor, dry mucous membranes, and a sunken anterior fontanelle. These signs usually appear only when the degree of dehydration is moderate to severe. Central venous pressure may be an unreliable determinant of extracellular volume.


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