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Article
June 1958

Functional Isosthenuria: An Isolated Reversible Renal Tubular Defect

Author Affiliations

Los Angeles

From the Department of Medicine, University of California Medical Center and Veterans' Administration Center. Chief, Metabolic Service, Veterans' Administration Hospital, and Associate Clinical Professor of Medicine, University of California Medical Center (Dr. Kleeman); Associate Clinical Professor of Medicine, University of California Medical Center (Dr. Maxwell); Intern, Medical Service, Veterans' Administration Hospital (Dr. Witlin).

AMA Arch Intern Med. 1958;101(6):1023-1028. doi:10.1001/archinte.1958.00260180013002
Abstract

True polyuria and polydipsia are symptoms frequently encountered in clinical medicine. Generally they indicate a serious organic disorder which must be systematically investigated for prompt and adequate diagnosis. Table 1 represents a schematic presentation of the major polyuric syn- dromes. In all instances the symptom arises whenever there is a decrease in the per cent of the water normally reabsorbed from the glomerular filtrate. As can be seen, this results from (1) a decrease in the reabsorption of water per se, (2) a decrease in the reabsorption of solutes, with, therefore, an obligatory excretion of water (absolute or relative osmotic diuresis*), or (3) a combination of one and two.

Recently a case was observed which, while classifiable, presented features which to our knowledge had not been previously described. This patient, an example of long-standing psychogenic polydipsia, was initially unable to concentrate his urine above the osmolality of his extracellular fluid,

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