View source for Nephrogenic diabetes insipidus causes

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{{Nephrogenic diabetes insipidus}}

===Acquired===
Nephrogenic DI (NDI) is most common in its acquired forms, meaning that the defect was not present at birth.  These acquired forms have numerous potential causes.  The most obvious cause is a kidney or systemic disorder, including [[amyloidosis]],<ref name="4typneph">{{Cite document
  | last = Wildin
  | first = Robert
  | title = What is NDI?
  | publisher = The Diabetes Inspidus Foundation
  | year = 2006
}} http://www.diabetesinsipidus.org/4_types_nephrogenic_di.htm</ref> [[polycystic kidney disease]],<ref name="NIHpub">http://kidney.niddk.nih.gov/kudiseases/pubs/insipidus/index.htm</ref> electrolyte imbalance,<ref name="pmid8621781">{{cite journal |author=Marples D, Frøkiaer J, Dørup J, Knepper MA, Nielsen S |title=Hypokalemia-induced downregulation of aquaporin-2 water channel expression in rat kidney medulla and cortex |journal=J. Clin. Invest. |volume=97 |issue=8 |pages=1960–8 |date=April 1996 |pmid=8621781 |pmc=507266 |doi=10.1172/JCI118628 |url=}}</ref><ref name="pmid185584">{{cite journal |author=Carney S, Rayson B, Morgan T |title=A study in vitro of the concentrating defect associated with hypokalaemia and hypercalcaemia |journal=Pflugers Arch. |volume=366 |issue=1 |pages=11–7 |date=October 1976 |pmid=185584 |doi= 10.1007/BF02486556|url=}}</ref> or some other kidney defect.<ref name="4typneph"/>

The major causes of acquired NDI that produce clinical symptoms (e.g. polyuria) in the adult are [[lithium (medication)|lithium]] toxicity and [[hypercalcemia]]. Chronic lithium ingestion - appears to affect the tubules by entering the collecting tubule cells through sodium channels, accumulating and interfering with the normal response to ADH (ADH Resistance) in a mechanism that is not yet fully understood. [[Hypercalcemia]] causes natriuresis (increased sodium loss in the urine) and water diuresis, in part by its effect through the [[calcium-sensing receptor]] ([[CaSR]]).

;Osmotic
Other causes of acquired NDI include: hypokalemia, post-obstructive polyuria, sickle cell disease/trait, amyloidosis, Sjogren syndrome, renal cystic disease, Bartter syndrome and various drugs (Amphotericin B, Orlistat, Ifosfomide, Ofloxacin, Cidofovir, Vaptanes).

In addition to kidney and systemic disorders, nephrogenic DI can present itself as a side-effect to some [[medication]]s.  The most common and well known of these drugs is [[lithium pharmacology|lithium]],<ref name="pmid2989335">{{cite journal |author=Christensen S, Kusano E, Yusufi AN, Murayama N, Dousa TP |title=Pathogenesis of nephrogenic diabetes insipidus due to chronic administration of lithium in rats |journal=J. Clin. Invest. |volume=75 |issue=6 |pages=1869–79 |date=June 1985 |pmid=2989335 |pmc=425543 |doi=10.1172/JCI111901 |url=}}</ref> although there are numerous other medications that cause this effect with lesser frequency.<ref name="4typneph"/>

===Hereditary===
This form of DI can also be hereditary:

{| class="wikitable"
|-
! Type
! [[OMIM]]
! Gene
! Locus
|-
| NDI1
| {{OMIM2|304800}}
| ''[[AVPR2]]''
| Usually, the hereditary form of nephrogenic DI is the result of an X-linked genetic defect which causes the [[vasopressin receptor]] (also called the V2 receptor) in the kidney to not function correctly.<ref name="4typneph"/><ref>{{OMIM|304800|DIABETES INSIPIDUS, NEPHROGENIC, X-LINKED}}</ref>
|-
| NDI2
| {{OMIM2|125800}}
| ''[[AQP2]]''
| In more rare cases, a mutation in the "[[aquaporin 2]]" gene impede the normal functionality of the kidney water channel, which results in the kidney being unable to absorb water. This mutation is often inherited in an autosomal recessive manner although dominant mutations are reported from time to time <ref name="4typneph"/><ref>{{OMIM|125800|DIABETES INSIPIDUS, NEPHROGENIC, AUTOSOMAL}}</ref>
|}


==Causes==
===Life Threatening Causes===

===Common Causes===
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Streptozocin]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}

===Causes in Alphabetical Order===
{{col-begin|width=80%}}
{{col-break|width=33%}}
* [[Streptozocin]]

{{col-break|width=33%}}
* Disease B

{{col-break|width=33%}}
* Disease C
{{col-end}}

==References==
{{reflist|2}}

[[category:Disease]]
[[Category:Nephrology]]
[[Category:Endocrinology]]
[[Category:Needs content]]

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