Solute loss plays a major role in polydipsia-related hyponatraemia of both water drinkers and beer drinkers.
QJM
; 96(6): 421-6, 2003 Jun.
Article
em En
| MEDLINE
| ID: mdl-12788960
ABSTRACT
BACKGROUND:
Polydipsia-related hyponatraemia is generally considered an acute dilutional state.AIM:
To determine whether solute loss plays a role in the pathogenesis of polydipsia-related hyponatraemia.DESIGN:
Prospective uncontrolled study.METHODS:
We studied routine biochemical volume-related parameters before and after 2 l isotonic saline infusion over 24 h, in 10 consecutive hyponatraemic polydipsia patients (mean age 55 +/- 11 years; 6 beer drinkers and 4 compulsive water drinkers) with initial urinary osmolality <220 mosm/kg H(2)O. In five of these patients, we measured balance data over 24 h.RESULTS:
Mean initial plasma protein concentration in the 10 studied polydipsia patients was 7 +/- 0.7 g/dl, unexpectedly high for an acute dilutional state. Mean plasma sodium concentration increased from 126 +/- 5 mmol/l before saline, to 135 +/- 5 mmol/l after infusion of 2 l isotonic saline (p < 0.01). Balance data in five polydipsia patients showed a mean decrease of 1.6 kg of their initial body weight and a mean salt retention of 406 mosm.DISCUSSION:
Polydipsia-related hyponatraemia is a mixed disorder, in which about half of sodium decrease is due to solute loss. This explains the apparent paradox of a normal plasma protein concentration, despite the increase in body weight due to water intoxication.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hiponatremia
Tipo de estudo:
Observational_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2003
Tipo de documento:
Article