Clinical salt deficits

Salt retention or salt deficit has a bearing on the body fluid volume. Both states are clinically difficult to recognize and quantitate. Salt deficit is particularly cumbersome in that regard since orthostatic blood pressure, heart rate changes, and simple physical inspection are inaccurate and unreliable. Salt deficit can be acute such as after hemorrhage or massive diarrhea, or more chronic as observed in Addison's disease, failure of renal sodium chloride transporters, drug-related effects, or distal nephron disease. Molecular genetics has given us important new insights into salt deficit syndromes. Recent recognition of a novel sodium storage compartment involving sodium binding to proteoglycans adds to the overall complexity of these syndromes.