• Diabetes Insipidus

    Definition

    Diabetes insipidus (DI) is a condition where water in the body is improperly removed from the circulatory system by the kidneys.
    There are 2 forms of DI:
    • Central diabetes insipidus (central DI)
    • Nephrogenic diabetes insipidus (NDI)

    Causes

    Antidiuretic hormone (ADH) controls the amount of water reabsorbed by the kidneys. ADH is made in the hypothalamus of the brain. The pituitary gland, at the base of the brain, stores and releases ADH.
    Central DI occurs when the hypothalamus does not make enough ADH.
    NDI occurs when the kidneys do not respond to ADH.
    Some diabetes insipidus is caused by genetic problems. Most others develop after an injury, illness, or exposure to a medication.
    Pituitary Gland
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    Risk Factors

    Factors that may increase your risk of DI include:

    Symptoms

    Symptoms may include:
    • Increased urination, especially during the night
    • Extreme thirst
    • Nighttime urination
    • Dehydration—fast heart rate, dry skin and mouth, fatigue, dizziness, confusion

    Diagnosis

    You will be asked about your symptoms and medical history. A physical exam may be done.
    Your bodily fluids may be tested. This can be done with:
    • Blood tests
    • Urine tests
    • Water deprivation test
    • Desmopressin challenge test
    Images may be taken of your bodily structures, usually the urinary tract or brain. This can be done with ultrasound or an MRI scan.

    Treatment

    Your doctor will work with you to address the underlying cause.
    Treatment may include:
    • For central DI—taking a synthetic form of ADH
    • For NDI
      • Drinking plenty of water
      • Treating any underlying cause
      • Following a low-sodium diet
      • Taking a diuretic

    Prevention

    There are no known ways to prevent diabetes insipidus. Talk to the doctor right away if you have excessive urination or thirst.

    RESOURCES

    American Diabetes Association http://www.diabetes.org

    Nephrogenic Diabetes Insipidus Foundation http://www.ndif.org

    CANADIAN RESOURCES

    Canadian Diabetes Association http://www.diabetes.ca

    Health Canada http://www.hc-sc.gc.ca

    References

    Central diabetes insipidus. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115774/Central-diabetes-insipidus. Updated June 7, 2017. Accessed August 24, 2017.

    Diabetes insipidus. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/kidney-disease/diabetes-insipidus. Updated January 13, 2014. Accessed August 24, 2017.

    Jain V. Ravindranath A. Diabetes insipidus in children. J Pediatr Endocrinol Metab. 2016 Jan;29(1):39-45. Available at: https://www.degruyter.com/view/j/jpem.2016.29.issue-1/jpem-2014-0518/jpem-2014-0518.xml. Accessed September 19, 2017.

    Lu H. Diabetes insipidus. Adv Exp Med Biol. 2017;969:213-225.

    Nephrogenic diabetes insipidus. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116727/Nephrogenic-diabetes-insipidus. Updated June 7, 2017. Accessed August 24, 2017.

    Rivkees SA, Dunbar N, Wilson TA. The management of central diabetes insipidus in infancy: desmopressin, low renal solue load formula, thazide diuretics. J Pediatr Endocrinol Metab. 2007;20(4):459-469.

    Toumba M, Stanhope R. Morbidity and mortality associated with desmopressin treatment. Pediatr Endocrinol Metab. 2006;19(3):197-201.

    Revision Information

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