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Correspondence
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Volume 357:941-942 August 30, 2007 Number 9
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The Syndrome of Inappropriate Antidiuresis

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 by Ellison, D. H.
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To the Editor: In the article on the syndrome of inappropriate antidiuresis (SIAD), by Ellison and Berl (May 17 issue),1 I disagree with the statement, in the discussion of areas of uncertainty, that "SIAD is characterized by a water excess, rather than a sodium deficit." In fact, salt depletion occurs, as shown in elegant observations made by William B. Schwartz between 1950 and 1970. If one continuously administers vasopressin in dogs maintained on zero salt and normal water intake, volume expansion with urinary salt loss occurs initially. This period is followed by an "escape" water diuresis, resulting in a reduction . . . [Full Text of this Article]


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