- A defect in the thirst mechanism results in adipsic hypernatremia, a syndrome characterized by chronic or recurrent hypertonic dehydration.
- The hypernatremia varies widely in severity and usually is associated with signs of hypovolemia such as tachycardia, postural hypotension, azotemia, hyperuricemia, and hypokalemia.
- Muscle weakness, pain, rhabdomyolysis, hyperglycemia, hyperlipidemia, and acute renal failure may also occur.
- DI usually does not exist at presentation but may develop during rehydration.
Treatment: Adipsic hypernatremia should be treated by administering water orally if the patient is alert and cooperative or by using hypotonic fluids (0.45% saline or 5% dextrose and water) via IV if the patient is not.