Inappropriate Renal Sodium Loss Reverted by Vena Cava Obstruction

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Abstract
Sodium balance is normally regulated by the interaction of the kidneys, the adrenal cortex, and one or several additional regulatory mechanisms, at present poorly defined (1-3). Excessive renal sodium loss, if not drug-induced, may occur in certain types of renal disease (salt-losing nephritis) (4-8) and in adrenal insufficiency. Renal sodium loss in the face of hyponatremia also occurs in a syndrome linked to overhydration secondary to inappropriate antidiuretic hormone release (9-14). Sodium loss is not correctable in renal disease but can be overcome by appropriate substitution therapy in adrenal insufficiency and by fluid restriction when it is associated with overhydration.

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