Nephrogenic diabetes insipidus (DI) is a known complication of lithium therapy, and patients affected by this disorder are highly vulnerable to hypernatremia when they cannot respond to their thirst mechanism, such as during the postoperative period. Bariatric surgery, gaining in popularity as a treatment for morbid obesity, is associated with major disturbances to patients' fluid balance and can result in disastrous consequences to the patient with DI. We report a case in which the diagnosis of lithium-induced nephrogenic diabetes insipidus (LINDI) evaded the primary team at a general hospital due to the remoteness of the lithium treatment and lack of classic symptomatology, such as polyuria and nocturia. The consult psychiatrist's identification of LINDI in a postoperative patient with erratic behaviors, polydipsia, and altered mental status led to life-saving interventions. This case underlines the importance of integrated care for bariatric patients.
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