Unreplaced water loss (which requires an impairment in either thirst or access to water) |
Insensible and sweat losses |
Gastrointestinal losses |
Central or nephrogenic diabetes insipidus |
Osmotic diuresis |
Glucose in uncontrolled diabetes mellitus |
Urea in high-protein tube feedings or recovery from azotemia |
Mannitol |
Hypothalamic lesions impairing thirst or osmoreceptor function |
Primary hypodipsia |
Reset osmostat in mineralocorticoid excess |
Water loss into cells |
Severe exercise or seizures |
Sodium overload |
Intake or administration of hypertonic sodium solutions |
ICU-acquired positive solute balance |
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