From the FDA Drug Label
Average and large doses of cortisone or hydrocortisone can cause elevation of blood pressure, salt and water retention, and increased excretion of potassium Average and large doses of hydrocortisone or cortisone can cause elevation of blood pressure, salt and water retention, and increased excretion of potassium
Glucocorticoids can increase water and sodium retention. This effect is more likely to occur with average and large doses of cortisone or hydrocortisone, and less likely with synthetic derivatives except when used in large doses 1, 2.
- Dietary salt restriction and potassium supplementation may be necessary to mitigate these effects.
From the Research
Glucocorticoids generally decrease water and sodium retention in the body, as evidenced by their ability to promote water and sodium excretion, particularly in the context of coadministration with mineralocorticoids 3. This effect is observed in studies where glucocorticoids, such as dexamethasone, increase water and sodium excretion without affecting water intake, leading to negative water and sodium balances 3. The mechanism behind this effect involves the renal actions of glucocorticoids, which can influence water and sodium ingestion by promoting their excretion 3. Additionally, glucocorticoids can reverse diluted hyponatremia via inhibiting the vasopressin receptor pathway in rats with heart failure, further supporting their role in decreasing water and sodium retention 4. However, it is essential to consider the specific context and the interplay between glucocorticoids and other hormones, such as mineralocorticoids, in regulating water and sodium balance 5, 6. Recent studies continue to explore the complex relationship between glucocorticoids and water balance, highlighting the need for careful consideration of their effects in various clinical scenarios, including hyponatremia management and pituitary surgery 7. Key points to consider include:
- Glucocorticoids promote water and sodium excretion, particularly when coadministered with mineralocorticoids
- The renal actions of glucocorticoids influence water and sodium ingestion by promoting their excretion
- Glucocorticoids can reverse diluted hyponatremia via inhibiting the vasopressin receptor pathway
- The interplay between glucocorticoids and other hormones, such as mineralocorticoids, is crucial in regulating water and sodium balance
- Recent studies continue to explore the complex relationship between glucocorticoids and water balance, with implications for various clinical scenarios.