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Adipsia Follow-up

  • Author: Vikas R Dharnidharka, MD, MPH; Chief Editor: Craig B Langman, MD  more...
Updated: Dec 30, 2014

Further Outpatient Care

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  • Monitor the serum electrolyte levels in order to ensure adequate fluid intake. The level of comprehension and compliance of the patient and parents determines the frequency of the visits.
  • In children with normal aqueous vasopressin (AVP) secretion, measuring urine osmolality may be sufficient for follow-up care. The goal of a urine osmolality is 400-600 mOsm/kg H2 O.

Further Inpatient Care

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  • Patients with adipsia must remain in the hospital until hypernatremia is diagnosed and corrected and until the patient is able to maintain fluid and electrolyte homeostasis.


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  • Patients who are unable to achieve an adequate fluid intake may be transferred to a chronic care facility where they can be kept under close supervision and receive behavioral therapy.


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  • Existing neurological deficits can be exacerbated by acute episodes of severe hypernatremia and cerebral hemorrhage.
  • Extrarenal losses of volume during episodes of gastroenteritis, more common in children, may lead to rehospitalization for worsening hypernatremia or other disorders of serum electrolytes.


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  • Prognosis is unfavorable unless behavioral therapy is successful. Most patients remain homebound or institutionalized and may develop further neurological handicaps.
Contributor Information and Disclosures

Vikas R Dharnidharka, MD, MPH Associate Professor and Director, Division of Pediatric Nephrology, St Louis Children's Hospital, Washington University in St Louis School of Medicine

Vikas R Dharnidharka, MD, MPH is a member of the following medical societies: American Academy of Pediatrics, American Society of Nephrology, American Society of Pediatric Nephrology, American Society of Transplantation

Disclosure: Received consulting fee from Bristol-Myers-Squibb for consulting; Received honoraria from Genzyme/Sanofi for advising; Received honoraria from American Society of Transplantation for speaking and teaching; Received grant/research funds from Bristol-Myers-Squibb, Novartis and Amgen for site PI on study. for: Bristol-Myers-Squibb; Genzyme-Sanofi; American Society of Transplantation; Novartis; Amgen.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Adrian Spitzer, MD Clinical Professor Emeritus, Department of Pediatrics, Albert Einstein College of Medicine

Adrian Spitzer, MD is a member of the following medical societies: American Academy of Pediatrics, American Federation for Medical Research, American Pediatric Society, American Society of Nephrology, American Society of Pediatric Nephrology, International Society of Nephrology, Society for Pediatric Research

Disclosure: Nothing to disclose.

Chief Editor

Craig B Langman, MD The Isaac A Abt, MD, Professor of Kidney Diseases, Northwestern University, The Feinberg School of Medicine; Division Head of Kidney Diseases, The Ann and Robert H Lurie Children's Hospital of Chicago

Craig B Langman, MD is a member of the following medical societies: American Academy of Pediatrics, American Society of Nephrology, International Society of Nephrology

Disclosure: Received income in an amount equal to or greater than $250 from: Alexion Pharmaceuticals; Raptor Pharmaceuticals; Eli Lilly and Company; Dicerna<br/>Received grant/research funds from NIH for none; Received grant/research funds from Raptor Pharmaceuticals, Inc for none; Received grant/research funds from Alexion Pharmaceuticals, Inc. for none; Received consulting fee from DiCerna Pharmaceutical Inc. for none.

Additional Contributors

Uri S Alon, MD Director of Bone and Mineral Disorders Clinic and Renal Research Laboratory, Children's Mercy Hospital of Kansas City; Professor, Department of Pediatrics, Division of Pediatric Nephrology, University of Missouri-Kansas City School of Medicine

Uri S Alon, MD is a member of the following medical societies: American Federation for Medical Research

Disclosure: Nothing to disclose.

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Anatomic relationships between pituitary and hypothalamic areas of interest with respect to regulation of antidiuretic hormone (ADH) secretion and thirst sensation. AN = Anterior (hypothalamic) nucleus; AP = Anterior pituitary; OC = optic chiasm; OVLT = Organum vasculosum of lamina terminalis; PA = Preoptic (hypothalamic) area; PP = Posterior pituitary; PVN = Paraventricular (hypothalamic) nucleus; SON = Supraoptic (hypothalamic) nucleus.
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