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DefinitionDiabetes insipidus is caused by the inability of the kidneys to conserve water, which leads to frequent urination and pronounced thirst.
Causes, incidence, and risk factors
Diabetes insipidus (DI) is an uncommon condition that occurs when the kidneys are unable to conserve water as they perform their function of filtering blood. The amount of water conserved is controlled by antidiuretic hormone ( ADH , also called vasopressin).
ADH is a hormone produced in a region of the brain called the hypothalamus. It is then stored and released from the pituitary gland, a small gland at the base of the brain.
DI caused by a lack of ADH is called central diabetes insipidus. When DI is caused by failure of the kidneys to respond to ADH, the condition is called nephrogenic diabetes insipidus. The major symptoms of diabetes insipidus are excessive urination and extreme thirst. The sensation of thirst stimulates patients to drink large amounts of water to compensate for water lost in the urine.
Central diabetes insipidus is caused by damage to the hypothalamus or pituitary gland as a result of surgery, infection, tumor , or head injury . Although rare, central DI is more common than nephrogenic DI.
Nephrogenic DI may also be caused by diseases of the kidney (for example, polycystic kidney disease ) and the effects of certain drugs (for example, lithium, amphotericin B, demeclocycline).
Signs and tests
The cause of the underlying condition should be treated when possible.
Central diabetes insipidus may be controlled with vasopressin (desmopressin, DDAVP). Vasopressin is administered as either a nasal spray or tablets.
Vasopressin is ineffective for patients with nephrogenic DI. In most cases, if nephrogenic DI is caused by medication (for example, lithium), stopping the medication leads to recovery of normal kidney function.
Hereditary nephrogenic DI is treated with fluid intake to match urine output and drugs that lower urine output. Drugs used to treat nephrogenic DI include the anti-inflammatory medication indomethacin and the diuretics hydrochlorothiazide (HCTZ) and amiloride.
The outcome depends on the underlying disorder. If treated, diabetes insipidus does not cause severe problems or reduce life expectancy.
Inadequate fluid consumption can result in the following complications:
Calling your health care provider
Call your health care provider if you develop symptoms that indicate diabetes insipidus.
If you have diabetes insipidus, contact your health care provider if frequent urination or extreme thirst return.
Update Date: 1/6/2003Todd T. Brown, M.D., Division of Endocrinology and Metabolism, Johns Hopkins Hospital, Baltimore, MD. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT