title: [Can water be poisonous?].
abstract: METHODS
  Two female patients aged over 80 years developed central nervous symptoms after drinking large amounts of water (more than 3 l per day).
  
  
  METHODS
  Both had a hypoosmolar hyponatremia that was induced by concomitant treatment with hydrochlorothiazid (HCT) in the one case and in the other case relied on a distal tubular damage due to reflux nephropathy.
  
  
  METHODS
  Hyponatremia was corrected after withdrawal of HCT and fluid restriction and central nervous symptoms disappeared rapidly.
  
  
  CONCLUSIONS
  Distal tubular urinary dilution can be disturbed by HCT and parenchymal renal disease and can result in symptomatic hyponatremia after drinking large amounts of water.
authors.affiliation: Medizinische Klinik, Universitätsklinikum Tübingen.
authors.forename: Ferruh
authors.initials: F
authors.lastname: Artunc
authors.affiliation: Medizinische Klinik, Universitätsklinikum Tübingen.
authors.forename: Günter
authors.initials: G
authors.lastname: Schnauder
authors.affiliation: Medizinische Klinik, Universitätsklinikum Tübingen.
authors.forename: Baptist
authors.initials: B
authors.lastname: Gallwitz
authors.affiliation: Urologische Klinik, Universitätsklinikum Tübingen.
authors.forename: Bastian
authors.initials: B
authors.lastname: Amend
mesh_terms: D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D004326:Drinking; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects; D007010:Hyponatremia / Q000139:chemically induced* / Q000517:prevention & control*; D014869:Water Intoxication / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D006852:Hydrochlorothiazide