Central diabetes insipidus (CDI) is a medical condition distinguished by the inability to concentrate urine due to arginine vasopressin (AVP) deficiency.1,2 AVP is a hormone primarily synthesized in the hypothalamus and secreted from the posterior pituitary gland. Its principal role is to regulate water balance by augmenting the water reabsorption by the kidneys. Lack of AVP results in excretion of large volumes of dilute urine. As a result, plasma osmolality is raised, compensated for by excessive thirst and increased fluid intake.1 Normal thirst is essential for maintaining water balance in CDI patients.3

Adipsic diabetes insipidus (ADI) is a rare but life-threatening disease. It is characterized by AVP deficiency and thirst absence, primarily resulting from structural or surgical damage to hypothalamic osmoreceptors.4 Only about 108 cases of ADI have been reported in the literature.5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17 ADI occurs in people aged 0.2 to 70 years old.5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17 Hypernatremia is common in ADI because of the inability to increase fluid intake promptly in response to raised plasma osmolality.18 Treatment includes desmopressin (DDAVP) replacement and water prescription.3,4,16 However, it is still difficult to maintain water balance and to achieve eunatremia in ADI, leading to numerous comorbidities and significant mortality.3 Previous publications on ADI were restricted to case reports or case series.4, 5, 6 Data about accompanying symptoms, the prevalence of hypernatremia, endocrinopathy, metabolic disorders, and treatment modalities were scarce.

This study was designed to investigate the clinical characteristics of hospitalized ADI patients.