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American Journal of Kidney Diseases

Reset Osmostat: The Result of Chronic Desmopressin Abuse?

  • Daniel C. Andreoli
    Affiliations
    Section of Nephrology, Division of Nephrology, Department of Internal Medicine, Rush University Medical Center, Chicago, IL
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  • William L. Whittier
    Correspondence
    Address correspondence to William L. Whittier, MD, Section of Nephrology, Department of Internal Medicine, Division of Nephrology, Rush University Medical Center, 1426 W Washington Blvd, Chicago, IL 60607.
    Affiliations
    Section of Nephrology, Division of Nephrology, Department of Internal Medicine, Rush University Medical Center, Chicago, IL
    Search for articles by this author
Published:February 18, 2017DOI:https://doi.org/10.1053/j.ajkd.2016.12.009
      A reset osmostat as a cause of hyponatremia can be found in a variety of clinical settings, including pulmonary and neurologic diseases, as well as in physiologic circumstances such as pregnancy. This teaching case describes a 72-year-old white man with a long-standing history of self-medicating with desmopressin acetate (DDAVP) who presented with profound hyponatremia. On discontinuation of DDAVP treatment, he was found to have a reset osmostat. The mild hyponatremia persisted on follow-up. We theorize that the reset osmostat may have developed secondary to long-standing DDAVP use.

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