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
Hospice and palliative medicine Hospice and palliative medicine Hospice and palliative medicine is a formal subspecialty of medicine in the United States that focuses on symptom management, relief of suffering and end-of-life care. In 2006, "hospice and palliative medicine" was officially recognized by the American Board of Medical Specialties, and is "co-sponsored" by Physicians who complete a residency in one of the "co-sponsoring" specialties are then eligible for further training in an ACGME-approved Hospice and Palliative Medicine fellowship program, after which they must pass the official examination to be board-certified in the subspecialty. In 2007, the American Osteopathic Association Bureau of Osteopathic Specialists approved