Beer potomania: Difference between revisions
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==[[Beer potomania natural history, complications, and prognosis|Natural History, Complications, and Prognosis]]== | ==[[Beer potomania natural history, complications, and prognosis|Natural History, Complications, and Prognosis]]== | ||
== Pathophysiology & Etiology== | == Pathophysiology & Etiology== | ||
The pathophysiologic mechanism of beer potomania can be understood through an example. Imagine someone who binged on 4 liters of beer (which essentially means 4 liters of water) with ingestion of roughly 200 mosm that day. To place this in context, a normal American diet contains 750 mosm/day, and all of it is excreted in urine to maintain a steady state. As a result of the ingestion of this large amount of beer (i.e.free water), the patient's anti diuretic hormone(ADH) (the hormone that causes the kidney to reabsorb free water) secretion is at its minimum to allow the kidneys to excrete maximally dilute urine. Since the maximal dilution that can be attained is 50mosm/L, the kidneys will excrete all the 200 mosm in the diet in 4 litres of urine (50mosm/L X 4L = 200 mosm). This will indeed maintain his sodium level.If this person in our example drinks his 5th litre of beer without taking any further osmoles, then he will become hyponatremic. This is beer potomania | The pathophysiologic mechanism of beer potomania can be understood through an example. Imagine someone who binged on 4 liters of beer (which essentially means 4 liters of water) with ingestion of roughly 200 mosm that day. To place this in context, a normal American diet contains 750 mosm/day, and all of it is excreted in urine to maintain a steady state. As a result of the ingestion of this large amount of beer (i.e.free water), the patient's anti diuretic hormone(ADH) (the hormone that causes the kidney to reabsorb free water) secretion is at its minimum to allow the kidneys to excrete maximally dilute urine. Since the maximal dilution that can be attained is 50mosm/L, the kidneys will excrete all the 200 mosm in the diet in 4 litres of urine (50mosm/L X 4L = 200 mosm). This will indeed maintain his sodium level.If this person in our example drinks his 5th litre of beer without taking any further osmoles, then he will become hyponatremic. This is beer potomania | ||
Revision as of 14:37, 22 August 2012
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Editor-in-Chief: Suresh Samson, M.D., Yale Bridgeport Hospital
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Beer potomania from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications, and Prognosis
Pathophysiology & Etiology
The pathophysiologic mechanism of beer potomania can be understood through an example. Imagine someone who binged on 4 liters of beer (which essentially means 4 liters of water) with ingestion of roughly 200 mosm that day. To place this in context, a normal American diet contains 750 mosm/day, and all of it is excreted in urine to maintain a steady state. As a result of the ingestion of this large amount of beer (i.e.free water), the patient's anti diuretic hormone(ADH) (the hormone that causes the kidney to reabsorb free water) secretion is at its minimum to allow the kidneys to excrete maximally dilute urine. Since the maximal dilution that can be attained is 50mosm/L, the kidneys will excrete all the 200 mosm in the diet in 4 litres of urine (50mosm/L X 4L = 200 mosm). This will indeed maintain his sodium level.If this person in our example drinks his 5th litre of beer without taking any further osmoles, then he will become hyponatremic. This is beer potomania
Differential Diagnosis
See the differential of hyponatremia
Electrolyte and Biomarker Studies
A value of Uosm < 100 mOsm/kg is indicative of a complete and appropriate suppression of antidiuretic hormone (ADH) secretion, a finding seen with either primary polydipsia (including ‘beer potomania’) or reset osmostat. Criteria used to diagnose the ‘beer potomania’ syndrome include
- A history of binge beer drinking
- Poor dietary intake
- Decreased serum sodium levels
- Low serum and urine osmolality
- Absence of other known causes of hyponatremia