Beer potomania syndrome


  • Constellation of electrolyte abnormalities that occur secondary to overconsumption of electrolyte-poor liquid with little other sources of nutrition (e.g. drinking a lot of beer and not eating much)
  • Poor overall electrolyte intake limits formation of normal renal urea gradient-->inability to excrete sufficient free water
  • Total body sodium may be depleted, yet still may have elevated urinary sodium/FENa due to dysfunction of water metabolism
  • Attention to proper nutrition during acute illness may obviate need for hypertonic saline

Clinical Features

Differential Diagnosis

Ethanol related disease processes



  • Chem 10
  • Osmolality
  • ADH


  • Signs, symptoms and laboratory values consistent with water intoxication
  • No evidence of another cause of hyponatremia (such as steroid] use, diuretic use, hyperlipidaemia, etc.)


  • If seizing or other severe symptoms, bolus hypertonic saline
  • Otherwise, gentle replacement of electrolytes with close attention paid to diet is important


Admit patient with:

See Also


  • Va Med. 1989 Jun;116(6):270-1. Beer potomania syndrome in an alcoholic. Harrow AS.