Hypernatremia, plasma sodium (Na) level above 145 mmol / L. Hypernatremia symptoms are mostly neurological. We aimed to present a case of Acute kidney injury (AKI) and hypernatremia that developed as a result of oral intake disorder (7-10 days) after the diagnosis of hypothyroidism and the initiation of levothyroxine in our case, who had no organic or psychological disease before.

A 35-year-old female patient without any illness was diagnosed with hypothyroidism one month ago and levotroxin treatment was started. Then, after psychological findings such as withdrawal, not speaking, and believing that he had cancer, he was referred to our clinic due to the high urea creatinine and Na values in the psychiatry outpatient clinic. The patient was admitted to the intensive care unit due to confused consciousness, respiratory rate >30 / min, and hypotensive (85/55 mmHg). The patient who was started on AKI and hypernatremia treatment (hypotonic (5% dextrose-0.45 NACl) fluid) was consulted with the psychiatry after the neurological pathology was ruled out with cranial diffusion MRI and examination. Because the patient was unconscious and the urine output was <200 cc / day, she was hemodialysis twice. The urea / creatinine / Na values measured in the following days of the patient decreased, urine output increased, and the urea, creatinine and Na values returned to normal on the 12th day of hospitalization. The patient was transferred to the service first and after his biochemical parameters were completely normal, he was transferred to the psychiatry clinic.

The purpose of presenting this case was to present a case of hypernatremia and AKI, which developed as a result of major depression and delirium without a history of organic and psychological diseases, and which developed in elderly, unattended or very young patients with high mortality and to emphasize the importance of its treatment.