MARK A. NEEDLE, M.D.
To the editor: DeFronzo, Goldberg, and Agus have expanded on the question of the osmostat with an interesting study on urinary dilution in hyponatremia (Ann Intern Med 84:538-542, 1976). There are three points that I should like them to clarify.
Was an attempt made to correct the hyponatremia with a low sodium diet and KCl? Laragh (authors' reference 18) studied normokalemic hyponatremic subjects with a variety of diagnoses who corrected to normal serum sodium concentrations when fairly modest potassium deficits were replaced. The reduction in creatinine clearances (75, 82, 95, and 99 ml/min) and the overnight maximal urinary concentrations (560,
MARK A. NEEDLE. Urinary Dilution in Hyponatremia. Ann Intern Med. 1976;85:536–537. doi: 10.7326/0003-4819-85-4-536
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Published: Ann Intern Med. 1976;85(4):536-537.
Endocrine and Metabolism, Fluid and Electrolyte Disorders, Nephrology.
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