Primary polydipsia Alcoholism may cause physiological thirst since ethanol inhibits vasopressin, the hormone primarily responsible for water retention in osmoregulation. The following conditions should also be excluded: DI, cerebral salt wasting, pseudohyponatraemia caused by hyperlipidemia or hyperparaproteinemia, SIADH, mineralcorticoid deficiency, salt-wasting nephropathy, nephrotic syndrome, chronic heart failure and cirrhosis. Tobacco smoking is an often overlooked factor linked to hyponatremia, due to the ADH-releasing effect of nicotine, although this is usually limited to heavy smokers. One study suggested that around 70% of patients with self-induced polydipsia were tobacco smokers. Diagnostic tests for primary polydipsia usually involves the fluid deprivation test to exclude ADH
German Agency for Quality in Medicine German Agency for Quality in Medicine The German Agency for Quality in Medicine (AEZQ) - in German "Ärztliches Zentrum für Qualität in der Medizin (ÄZQ)", established in 1995 and located in Berlin, co-ordinates healthcare quality programmes with special focus on evidence-based medicine, medical guidelines, patient empowerment, patient safety programs, and quality management. AEZQ is a non-profit organization owned by the German Medical Association and the National Association of Statutory Health Insurance Physicians. AEZQ initiated several quality programs for the German healthcare system: It established the German Program for evidence based medical guidelines in the late 90s. Based upon guideline standards