Case of the Month #48 Nephrogenic DI

Published 25/04/2024


Theme: Renal, Endocrine and Metabolic 

A 52 year old Gentleman was admitted to ITU following an in-hospital PEA cardiac arrest. He is known case of multiple myeloma; post autologous stem cell transplant with subsequent neutropenic sepsis. He has a background of Hypertension and Bipolar Depression on Lithium. 

The patient was found to be Polyuric and has poor GCS on sedation hold. Biochemistry on admission showed Na 145, the following day Na was found to be 159 and continued to rise up to 173 despite careful fluid management.