Among the many potential contributing factors are Administration of drugs that impair renal water excretion Administration of hypotonic fluids Impaired renal function Nonosmotic vasopressin release due to intravascular volume depletion In addition, adrenal insufficiency has become increasingly common among AIDS patients as the result of cytomegalovirus adrenalitis, mycobacterial infection, or interference with adrenal glucocorticoid and mineralocorticoid synthesis by ketoconazole.