To the Editor.—
The case report of Rogers and Kurtzman in "Renal Failure, Uncontrollable Thirst, and Hyperreninemia: Cessation of Thirst with Bilateral Nephrectomy" (225: 1236, 1973) raises the possibility that propranolol should have been tried before subjecting the patient to bilateral nephrectomy. Propranolol, a beta-adrenergic blocker has been appropriately labeled a renin lowering drug by Laragh,1 since it has been found to inhibit renin secretion in man and animals. The mechanism by which it lowers plasma renin is not clear. The effect could be central or intrarenal via beta-adrenergic pathway blockade. Thus, by inhibiting the renin secretion of their patient with propranolol, the authors possibly could have decreased the marked thirst, hopefully achieving the same goal as by removing both his kidneys.It should be noted also, that their patient was receiving testosterone, presumably for the treatment of anemia of chronic renal failure. Several studies have shown that testosterone does improve anemia of chronic renal failure.
Dua SL. Thirst Control. JAMA. 1973;226(13):1570. doi:10.1001/jama.1973.03230130058029