In NDI patients with hypernatremia, is the hypernatremia due to the inability of the patient to drink the huge volumes of water needed to maintain fluid balance or the blunting of thirst?

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Topic: Health Care
Author: Wildin, Robert
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Most patients with NDI have normal thirst mechanisms. They can prevent substantial increases in blood sodium by drinking sufficient water, which most can, although many run slightly high sodium levels anyway. Rarely, patients with NDI who have had severe hypernatremic dehydration may have damaged their thirst center in the brain, and may have problems regulating their own water intake. More commonly, the problem with drinking enough water is simply access. Infants in a crib cannot freely access water, no matter how thirsty, unless they are provided with water bottles. Similarly, our society frequently runs on a regimental schedule that assumes water breaks do not need to occur frequently. Education and accommodation are the best solutions to those problems.