MALCOLM COX, M.D.; JOSEPH GUZZO, M.D.; GAIL MORRISON, M.D.; IRWIN SINGER, M.D.
To the editor: Demeclocycline is known to cause nephrogenic diabetes insipidus in humans and to inhibit ADH-induced osmotic water flow in the toad urinary bladder (1). The drug has been used successfully in the treatment of the syndrome of inappropriate antidiuretic hormone secretion (2-4), allowing patients free access to water. Recently De Troyer and colleagues (5) have reported that demeclocycline causes both a water and a sodium diuresis in patients with cirrhosis. However, there was no change in plasma sodium concentration despite the production of a hypotonic urine (mean urine osmolality, 183 mosmol/kg). Even assuming that the patients excreted no urea (that is, attributing all the urine osmolality [Uosm] to electrolytes) and had zero insensible water loss, it is difficult to understand why the plasma
COX M, GUZZO J, MORRISON G, SINGER I. Demeclocycline and Therapy of Hyponatremia. Ann Intern Med. ;86:113–114. doi: 10.7326/0003-4819-86-1-113
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Published: Ann Intern Med. 1977;86(1):113-114.
Endocrine and Metabolism, Fluid and Electrolyte Disorders, Nephrology.
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