Study On The Relationship Between Salt Input And Urine Output Of Cerebral Salt Wasting Syndrome

[Objective]To evaluate the clinical significance of the relationship betweensalt input and urine output of Cerebral Salt Wasting Syndrome，and toprovide the basis for the pathogenesis research and the treatmentprinciples of Cerebral Salt Wasting Syndrome by exploring serum sodiumconcentration, urine sodium concentration, urine volume, salt input andurine sodium volume in cases of Cerebral Salt Wasting Syndrome, cases ofhyponatremia with other diseases and cases of traumatic brain injurywithout hyponatremia.[Methods]We tested serum sodium concentration, urine sodium in10cases ofCerebral Salt Wasting Syndrome,22cases of hyponatremia with otherdiseases and20cases of traumatic brain injury without hyponatremia byion selective electrode method, and recorded daily amount of sodiumsupplement and urine output. The data of CSWS cases was compared with theother two control groups respectively. Linear regression analysis ofurine output and salt input was performed on all cases of these groups.Based on the analysis results，CSWS cases were divided into two groups，and independent-Samples T test was performed on the means of data of eachgroups. Wilcoxon signed-rank test of salt input and urine sodium outputwas performed on the cases of CSWS group and the group of traumatic braininjury without hyponatremia. We analyze the data with SPSS(version17.0).[Results]1. There was linear regression relationship of salt input and urineoutput in CSWS group, P＜0.01.2. There was linear regression relationship of salt input and urine output of the data of Low-sodium period of CSWS group, P＜0.01.3. To calculate the data of each of the10CSWS cases,5cases haslinear regression relationship of salt input and urine output, P＜0.05;while the other5cases cannot be considered has a linear regressionrelationship, P＞0.10.4. Compared with the non-linear regression group of CSWS, the linearregression group of CSWS has more salt input, P＜0.05.5. Compared with the hyponatremia with other diseases group, the CSWSgroup has more salt input and urine output, P＜0.01；but the means ofurine output/salt input of two groups cannot be considered not equal，P＞0.90.6. Compared with the traumatic brain injury without hyponatremiagroup, the CSWS group has more salt input and urine output, P＜0.01；but the means of urine output/salt input of two groups cannot be considerednot equal，P＞0.20.7. The hyponatremia with other diseases group cannot be consideredhas a linear regression relationship of salt input and urine output, P＞0.30.8. There was linear regression relationship of salt input and urineoutput in traumatic brain injury without hyponatremia group, P＜0.05.9. Salt input and urine sodium output of CSWS group cannot beconsidered not equal，P＞0.50.10. Salt input and urine sodium output of traumatic brain injurywithout hyponatremia group cannot be considered not equal，P＞0.80.[Conclusions]1. The pathogenesis of CSWS is: under the influence of theintracranial disease, some nerve centre cells reduced the serum sodiumbenchmark and adjusted renal to excrete sodium by regulating natriureticpeptide secretion, which will lead to hyponatremia and hypovolemia. 2. Diagnostic criteria of CSWS：symptoms of salt input equals withurine sodium output and urine output depends on salt input should beconsidered as the diagnostic criteria of CSWS. Increasing sodiumsupplement will increase the amount of urine，it should not be diagnosedwith Diabetes insipidus; reducing sodium supplement will reduce theamount of urine, it should not be diagnosed with SIADH, these are symptomsof CSWS.3. Therapeutic Principle of CSWS： Treatment targets of CSWS shouldbe aimed at improving the symptoms of hyponatremia and surviving thepatients through the period of low-sodium comfortably. It should not beaimed at correcting low serum sodium. Treatment with large amount ofsodium supplement should be avoided.