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Clinical Characteristics

  1. A defect in the thirst mechanism results in adipsic hypernatremia, a syndrome characterized by chronic or recurrent hypertonic dehydration.
  2. The hypernatremia varies widely in severity and usually is associated with signs of hypovolemia such as tachycardia, postural hypotension, azotemia, hyperuricemia, and hypokalemia.
  3. Muscle weakness, pain, rhabdomyolysis, hyperglycemia, hyperlipidemia, and acute renal failure may also occur.
  4. 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.

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