Normal Diluting Capacity in Hyponatremic Patients

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Abstract
Four patients with chronic illnesses and stable hyponatremia and plasma hypotonicity had normal urinary diluting capacity, with excretion of > 80% of a standard water load (20 ml/kg) within 4 h and maintenance of a urine osmolality < 100 mosmol/kg, during sustained water diuresis. Administration of a chronic salt load did not correct the hyponatremia. It was stabilized after treatment of the underlying medical condition. These subjects may represent a true resetting of the osmostat or a variant of the syndrome of inappropriate antidiuretic hormone secretion.