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      Salt Wastage, Plasma Volume Contraction and Hypokalemic Paralysis in Self-Induced Water Intoxication

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          Abstract

          Eleven episodes of severe hyponatremia secondary to hiccup-induced potomania were recorded in 3 years in a man who had essential hypertension, a low protein intake and a normal diluting ability. Paradoxical increase in hematocrit and plasma protein with acute extensive natriuresis was associated as well as urine potassium loss and hypokalemia producing paralysis in 1 episode. During a chronic water loading test, the defect in water excretion was related to a low urine solute delivery which was partially reverted by the natriuretic response to plasma volume expansion, promoting water diuresis. In acute water intoxication, this natriuretic response was exaggerated, producing a brisk water diuresis. Plasma volume was rapidly normalized but without any improvement in plasma sodium due to the concomitant negative sodium balance. Thus, water diuresis persisted until plasma volume was significantly contracted. Potassium loss appeared to be related to sodium excretion. Metabolic disturbances have not reoccurred despite persistent hiccup and potomania during 2 years of urea therapy.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1993
          1993
          12 December 2008
          : 64
          : 4
          : 570-575
          Affiliations
          Department of Internal Medicine and Renal Unit, University Hospital, Brest, France
          Article
          187402 Nephron 1993;64:570–575
          10.1159/000187402
          8366983
          © 1993 S. Karger AG, Basel

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          Page count
          Pages: 6
          Categories
          Original Paper

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