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However, this approach does not take account of the metabolic response to trauma, which provides a powerful non-osmotic stimulus to AVP secretion, with resultant water retention, or of the response to physiological stress, which both reduces sodium excretion and increases potassium excretion, or of the redistribution of potassium that occurs as a result of tissue damage. Redistribution of fluid may affect the result. It can occur as a result of heavy metal poisoning, or from the effects of toxins and inherited metabolic diseases such as cystinosis.
