Putterman C, Levy L, Rubinger D
Division of Medicine, Hadassah University Hospital, Ein-Kerem, Jerusalem, Israel.
Am J Kidney Dis. 1993 Feb;21(2):206-9. doi: 10.1016/s0272-6386(12)81095-x.
Water loading only rarely results in adverse effects due to the high efficiency of the kidney in excreting free water. However, when renal diluting ability is impaired, such as in inappropriate vasopressin secretion, water intoxication can occur in otherwise normal individuals. We report the case of a 19-year-old man with acute voluntary water intoxication following exercise, which resulted in a transient defect in renal diluting capability. Hyponatremia was further complicated by rhabdomyolysis. We review the literature regarding other cases of hyponatremia following excessive water intake, and discuss the possible association between hyponatremia and rhabdomyolysis. We conclude that monitoring of muscle enzymes is indicated in acute hyponatremia, to allow for timely intervention intended to prevent rhabdomyolysis-associated acute renal failure.
由于肾脏排泄自由水的效率很高，水负荷很少会导致不良反应。然而，当肾脏稀释能力受损时，如抗利尿激素分泌不当，原本正常的个体也可能发生水中毒。我们报告一例19岁男性在运动后发生急性自愿性水中毒的病例，该病例导致了肾脏稀释能力的短暂缺陷。低钠血症因横纹肌溶解而进一步复杂化。我们回顾了关于过量饮水后低钠血症其他病例的文献，并讨论了低钠血症与横纹肌溶解之间可能的关联。我们得出结论，急性低钠血症时应监测肌肉酶，以便及时进行干预，预防与横纹肌溶解相关的急性肾衰竭。
