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Severe life-threatening hypernatremia can be associat-

Primary polydipsia

> 500

< 5 pg/mL

Little or none

ed with illness or water deprivation

* Water intake is restricted until the patient loses 3%-5% of weight or until three consecutive hourly determinations of urinary osmolality are within 10% of each other (Caution must be exercised to ensure that the patient does not become excessively dehydrated.) Aqueous AVP (5 U subcutaneous) is given, and urine osmolality is measured after 60 minutes. The expected responses are given above.

* Water intake is restricted until the patient loses 3%-5% of weight or until three consecutive hourly determinations of urinary osmolality are within 10% of each other (Caution must be exercised to ensure that the patient does not become excessively dehydrated.) Aqueous AVP (5 U subcutaneous) is given, and urine osmolality is measured after 60 minutes. The expected responses are given above.

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