Beer potomania syndrome

Background

The pathophysiology involves the inability to excrete sufficient free water, based on a loss of normal renal urea gradients. Patients may actually be total-body sodium depleted, yet have elevated urinary sodium and fractional sodium excretion due to this disorder of water metabolism. Attention to proper nutrition during the acute illness may obviate the need for potentially hazardous administration of hypertonic saline

Diagnosis

1. a history of chronic alcohol ingestion (in a hypotonic form)
2. protein malnutrition
3. signs, symptoms and laboratory values consistent with water intoxication, including hyponatraemia, hypochloraemia and, usually, hypokalaemia
4. no evidence of another cause of hyponatraemia such as steroid use, diuretic use, hyperlipidaemia, etc.

Work-Up

Chem 10

DDx

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Treatment

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Disposition

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See Also

Tox: ETOH Intoxication

Tox: ETOH Withdrawl

Source

Va Med. 1989 Jun;116(6):270-1. Beer potomania syndrome in an alcoholic. Harrow AS.