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Frequency of hyponatremia and nonosmolar vasopressin release in the acquired immunodeficiency Vitting KE, Gardenswartz MH, Zabetakis PM, Tapper ML, Gleim GW, Agrawal M, Michelis MF. - last modified 2013-05-16 13:23
JAMA. 1990 Feb 16;263(7):973-8.


The frequency and pathophysiology of hyponatremia were studied in the acquired

immunodeficiency syndrome. Of 71 hospitalized patients surveyed retrospectively,

hyponatremia was observed in 37 (52%). Of 48 patients studied

prospectively, 27 (56%) were hyponatremic. In 16 hyponatremic patients, volume

status; serum and urine osmolalities; renal, adrenal, and thyroid function;

and plasma vasopressin levels were assessed. Urine osmolalities were inappropriately elevated (mean, 377 mmol/kg of water) relative to serum osmolalities (mean, 268 mmol/kg of water). Four patients had moderate renal insufficiency. Plasma vasopressin levels were elevated in 15 patients, with the highest levels seen in patients who died (median, 7.08 pmol/L). Hyponatremia of multiple etiologies occurred in a majority of inpatients with the acquired immunodeficiency syndrome, often following the administration of hypotonic fluids, and was associated with a 30% (8/27) short-term mortality.