Sodium Replacement in Addison's Disease Patients on Furosemide

Pathophysiology and Management

• The use of furosemide in patients with Addison's disease compounds renal sodium loss due to aldosterone deficiency, leading to hyponatremia 1

Critical Management Principles

• The Endocrine Society recommends optimizing fludrocortisone dosing to achieve physiologic mineralocorticoid replacement, rather than supplementing with sodium chloride, to address the underlying hormonal deficiency in Addison's disease patients on furosemide 1