To the Editor: I should like to take issue with the statement made by Moses and Miller (N Engl J Med 291:1234–1239, 1974) that the cardinal feature of water retention in the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is a urine osmolality that is hypertonic to plasma. This common misconception is pointed out by Schwartz and Bartter in their review of the disease (Bartter EC, Schwartz WB: The syndrome of inappropriate secretion of antidiuretic hormone. Am J Med 42:794, 1967). Here the authors state that it is not necessary for the urine to be hypertonic to the plasma.
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