A patient having long-term hemodialysis with uncontrollable thirst, persistent hyponatremia, and expanded extracellular volume was found to have hyperreninemia before and after hemodialysis. The clinical course of this patient and a similar one from the literature confirm previous investigative studies that suggest that elevated levels of circulating renin (angiotensin) may directly stimulate the thirst center of the hypothalamus. Bilateral nephrectomy in both patients resulted in the dramatic cessation of thirst.
Rogers PW, Kurtzman NA. Renal Failure, Uncontrollable Thirst, and HyperreninemiaCessation of Thirst With Bilateral Nephrectomy. JAMA. 1973;225(10):1236–1238. doi:10.1001/jama.1973.03220380048013
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