Children who resist drinking are tube fed to provide the water needed. Their fluid replacement needs are individually calculated during the hospitalization. Daily weights, urine specific gravity measurement, and intake and output at home may be required. Long term mismanagement of DI, however can result in bladder, kidney, and pelvic damage, and central nervous system damage, vascular changes, and dehydration can occur. Children requiring IV therapy must be monitored closely due to the high risk for fluid overload.
Weight gain occurs as fluids are retained and the child becomes weak and lethargic.
The child may appear bloated. Anorexia, nausea, and vomiting develop as fluid and electrolyte balance deteriorates. The child eventually has confusion, convulsions, and coma. Fluid overload is considered life threatening. The goals for treatment are to reduce the fluid overload and raise the serum sodium level and osmolarity.