Nephrogenic diabetes insipidus with new onset diabetic ketoacidosis in a child - challenges in fluid and electrolyte management.

This case illustrates the challenges in managing hypovolemic shock, hyperosmolality, and extreme electrolyte derangements driven by NDI and DKA, as both disease processes drive excessive urine output, electrolyte and acid-base imbalances, and rapid fluctuation in osmolality.