WHAT IS IT? Hyponatraemia (dilutional) secondary to excessive alcohol consumption and undernourishment (i.e low protein/salt)
HOW? Malnourished chronic alcoholics with minimal solute/ protein intake are susceptible to water toxicity at small volumes (due to loss of urea concentrating gradient) compared to healthy individuals with normal renal function (normal adults can drink up to 20L a day without subsequent hyponatremia).
*Fluid intake over 4-5 L can push them into hyponatremia [Obligatory solute loss is ~250mOsm/day]
MECHANISM:
REFERENCES
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