Abstract
In 5 hyponatremic, cirrhotic patients, demeclocycline hydrochloride was used to inhibit the hydroosmotic effect of vasopressin. In 4, renal impairment developed during the 7-20 days of demeclocycline hydrochloride (900-1200 mg/day) administration. In these 4 patients, creatinine clearance fell (72-20 ml/min, P < .01) as blood urea N (12-47 mg/dl, P < .02) and serum creatinine (0.9-4.2 mg/dl, P < .01) levels rose. The azotemic effect of the drug could not be accounted for consistently by volume depletion secondary to its natriuretic effect. A close correlation between plasma demeclocycline levels and its azotemic effect was observed. A nephrotoxic effect of demeclocycline severely limits its usefulness in treating hyponatremia in the cirrhotic patient.

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