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Abstract: FR-PO557

Beer Potomania Is Associated With Normal Uric Acid Homeostasis and Alcohol Tubulopathy

Session Information

Category: Fluid‚ Electrolyte‚ and Acid-Base Disorders

  • 1002 Fluid‚ Electrolyte‚ and Acid-Base Disorders: Clinical


  • Braden, Gregory Lee, UMass Chan Medical School-Baystate, Springfield, Massachusetts, United States
  • Abdullin, Marat, UMass Chan Medical School-Baystate, Springfield, Massachusetts, United States
  • Landry, Daniel L., UMass Chan Medical School-Baystate, Springfield, Massachusetts, United States
  • Hodgins, Spencer, UMass Chan Medical School-Baystate, Springfield, Massachusetts, United States
  • Mulhern, Jeffrey, UMass Chan Medical School-Baystate, Springfield, Massachusetts, United States

Group or Team Name

  • Kidney Care and Transplant Service of N.E.

Uric acid homeostasis has never been studied in beer potomania (BP) & whether alcohol related tubulopathies occur in BP is unkown.


We reviewed all patients (pts) over 6 years referred to our service for severe hyponatremia caused by BP. 8 pts were found, 5 male / 3 female drinking 12-16 cans of beer daily. We looked for signs of volume depletion & compared blood pressure and pulse at admission to 24 hrs later after normal or 3% saline infusion. We also mearuerd uric acid dynamics on admission & 24 & 48 hours during Na correction. All the data shown are mean+/- SEM along with the range of levels found.


The mean blood pressure initially was 113+/64 vs 131 /75 24 hours after saline, p<.01. Heart rate decreased from 107+-3 b/min to 81+-5 b/min after 24 hrs, p<.02, suggesting ECF volume depletion. 6 pts developed tremulousness, 1 delirium tremens & 1 hallucinations. Serum Na was initally 108+-3 (95-117) mEq/l, POSM 239 +-14 (216-270) mOsm/kg, urine NA 13 +-2 (8-19) mEq/l, Fractional Excretion (FE) of Na was 0.6+-.04 (.4-.9)% & UOSM 231+-14 (127-270) mOsm/kg. All pts had hypokalemia, 3.2 +- .2 (2.9- 3.6) mEq/l & low serum albumin 3.4+-.2 (3-3.6) gm/dl. Serum uric acid (UA) was normal in all 8 pts 4.0 +- 0.4 (3.4-5) mg/dl & the FE UA was normal in all 8 pts, 8.4+-1 (2-11)%. The serum UA and FE Ua remained normal during 24 & 48 hrs of Na correction. Serum Mg was low in 4/8 pts(1.3-1.5) mg/dl with the FE Mg increased at >2% in all 4. Serum PO4 was low in 4/8 pts (2.6-3.0) mg/dl with a FE PO4 of 19-24%. IV Mg and PO4 were used in the 4 pts. 3 pts were treated with hyperteonic saline clamp and q 6 hr DDAVP. 5 pts needed IV D5 & W to prevent overcorrection. No CPM occurred.


BP often presents with signs of ECF volume depletion which can be subtle & is associated with normal serum UA levels and normal ranges of FE of UA despite serum Na levels <100 mEq/l. The urine OSM in these pts is >100 mOsm/kg suggesting serum ADH stimulation possibly from ECF volume depletion. All of our pts developed clinical alcohol withdrawal and half had renal Mg and PO4 wasting associated with alcohol tububopathy. Normal UA nd FE UA differentiates BP from SIADH in alcoholics.


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