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Central essential hypernatremia: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Causes of central essential hypernatremia
The causes of hypernatremia may be, in addition to forms of diabetes insipidus, isolated loss of the feeling of thirst (some organic lesions of the central nervous system - craniopharyngiomas, pinealomas, meningiomas, hydrocephalus, cysts of various localizations), limitation of fluid intake as a result of a certain life situation or due to a serious condition (coma), excessive sweating, excessive sodium intake with food, excessive sodium retention in hyperaldosteronism.
Pathogenesis of central essential hypernatremia
It is believed that dysfunction of the osmoreceptor centers of the hypothalamus occurs. Pathological examination does not reveal any micro- or macrostructural lesions of the hypothalamus and pituitary gland.
Symptoms of central essential hypernatremia
Central essential hypernatremia is manifested by chronic hypernatremia, moderate dehydration and hypovolemia. It occurs most often at the subclinical level. Adipsia without polyuria is possible. As a rule, a slightly reduced level of antidiuretic hormone corresponds to the state of hypovolemia. Some authors consider this syndrome a partial form of diabetes insipidus.
Differential diagnosis should be made with the complete form of diabetes insipidus of both neurogenic and nephrogenic genesis, with hypernatremia, which is possible with diabetes mellitus, with hyperaldosteronism.
Treatment of central essential hypernatremia
A long-term salt-free diet and sufficient fluid intake are necessary. For other manifestations of diabetes insipidus, appropriate treatment is prescribed.
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