Psychogenic adipsia presenting as acute kidney injury: Case report and review of disorders of sodium and water metabolism in psychiatric illness

摘要

Consultation on cases of psychogenic polydipsia (PPD) and hyponatremia is common on a Consultation-Liaison (C-L) psychiatry service. We report on a much less common case of psychogenic adipsia-oligodipsia that presented with acute kidney injury (AKI).Adipsia-oligodipsia is a condition marked by the absence of thirst that typically presents with hyper-natremic dehydration.1 Thirst is tightly linked to serum osmolarity and intravascular volume status and is stimulated by hypertonicity and hypovolemia. The hypertonic signal to thirst is engaged much earlier than that of hypovolemia. Adipsia typically results from central lesions that impair normal thirst, antidiuretic hormone (ADH) secretion, or both.