{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:12:50Z","timestamp":1788149570843,"version":"build-2803163510"},"reference-count":15,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,12,1]]},"abstract":"<jats:p>Cerebral salt wasting is an increasingly recognized condition in pediatrics and is characterized by inappropriate natriuresis and volume contraction in the presence of cerebral pathology. Diagnosis can be difficult and therapy challenging. A few single case reports of the successful use of fludrocortisone exist. We report 4 patients with cerebral salt wasting, all of whom presented with hyponatremia in the presence of known intracerebral pathology. All had clinically significant hyponatremia, and 3 had hyponatremic seizures. Two of the patients also satisfied clinical criteria for diabetes insipidus. They all were treated with regimens using increased sodium and fluid administration but experienced ongoing salt wasting. Fludrocortisone was instituted in all 4 patients and in 3 resulted in rapid improvement in net sodium balance, enabling the weaning of hypertonic fluids and stabilization of serum electrolytes. In 3 patients, fludrocortisone treatment was complicated by hypokalemia, and in 1 patient by hypertension, which necessitated a dose reduction or brief cessation of therapy. Duration of therapy was 4 to 125 days. Cerebral salt wasting presents considerable management challenges; however, fludrocortisone therapy can be an effective adjunct to treatment.<\/jats:p>","DOI":"10.1542\/peds.2006-0702","type":"journal-article","created":{"date-parts":[[2006,11,14]],"date-time":"2006-11-14T02:38:33Z","timestamp":1163471913000},"page":"e1904-e1908","source":"Crossref","is-referenced-by-count":50,"title":["Fludrocortisone Therapy in Cerebral Salt Wasting"],"prefix":"10.1542","volume":"118","author":[{"given":"Craig E.","family":"Taplin","sequence":"first","affiliation":[{"name":"Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher T.","family":"Cowell","sequence":"additional","affiliation":[{"name":"Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Silink","sequence":"additional","affiliation":[{"name":"Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey R.","family":"Ambler","sequence":"additional","affiliation":[{"name":"Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2006,12,1]]},"reference":[{"key":"2021120823122340500_R1","doi-asserted-by":"crossref","unstructured":"Kurtoglu S, Atabek ME, Keskin M, Patiroglu T, Kumandas S, Topaloglu N. Rhabdomyosarcoma with coexistent diabetes insipidus and cerebral salt wasting as postoperative complication. Pediatr Int.\u20082006;48:79\u201381","DOI":"10.1111\/j.1442-200X.2006.02161.x"},{"key":"2021120823122340500_R2","doi-asserted-by":"crossref","unstructured":"Ganong CA, Kappy MS. Cerebral salt wasting in children: the need for recognition and treatment [published correction appears in Am J Dis Child. 1993;147:369]. Am J Dis Child.\u20081993;147:167\u2013169","DOI":"10.1001\/archpedi.1993.02160260057022"},{"key":"2021120823122340500_R3","doi-asserted-by":"crossref","unstructured":"Kappy MS, Ganong CA. Cerebral salt wasting in children: the role of atrial natriuretic hormone. Adv Pediatr.\u20081996;43:271\u2013308","DOI":"10.1016\/S0065-3101(24)00076-8"},{"key":"2021120823122340500_R4","doi-asserted-by":"crossref","unstructured":"Kinik ST, Kandemir N, Baykan A, Akalan N, Yordam N. Fludrocortisone treatment in a child with severe cerebral salt wasting. 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