Fenando A
Managing the sodium level in the beer potomania patient is so challenging. Every 5 to 6 people with beer potomania develop ODS during treatment. Close monitoring on the sodium level with severe hyponatremia occurs commonly in patient with alcoholism. Many pathological mechanisms contribute to this condition, one of the most unique mechanism presents in beer potomania. The beer does not contain enough sodium but contains enough calories to prevent protein break down. This will result lower urine osmolality due to low urea and sodium in the urine. Daily heavy beer drinker will have maximally diluted urine, hence the total volume of urine will be dependent only on the solute intake. Even little increment in solute intakes could reverse this mechanism and produce rapid elevation in serum sodium level. With that being said, correction modest correction of serum sodium are the main principle of the treatment. D5W or desmopressin or both is frequently needed to slow down the sodium progression.
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