Diabetes insipidus overview: Difference between revisions

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Revision as of 12:14, 6 July 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Diabetes insipidus (DI) is a syndrome characterized by the excretion of abnormally large volumes of dilute urine. It can be caused by any of 4 fundamentally different defects that must be distinguished for safe and effective management. They are: (1) pituitary DI also called neurogenic or central DI, due to inadequate production and secretion of antidiuretic hormone, arginine-vasopressin (AVP); (2) gestational DI due to degradation of arginine vasopressin by an enzyme made in placenta; (3) primary polydipsia, due to suppression of arginine vasopressin secretion by excessive fluid intake; and (4) nephrogenic DI due to renal insensitivity to the antidiuretic effect of AVP. Patients with DI typically present with excessive day and nighttime urination, excessive drinking of fluids in order to compensate for the lost fluids in urine which may lead to electrolyte imbalances such as hypo- or hypernatremia. The causes of Diabetes insipidus are unique to the type of the diabetes insipidus caused, and the treatment should be targeted at understanding the underlying cause of the disease.

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Diabetes insipidus other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Surgery

Medical Therapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

References

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 ==Overview==
-'''Diabetes insipidus''' ('''DI''') is a [[disease]] characterized by excretion of large amounts of severely diluted [[urine]], which cannot be reduced when fluid intake is reduced. It denotes inability of the kidney to concentrate urine. DI is caused by a deficiency of [[antidiuretic hormone]] (ADH), also known as vasopressin, or by an insensitivity of the [[kidney]]s to that hormone.  It can also be induced [[iatrogenic]]ally by the diuretic [[conivaptan]].
+Diabetes insipidus (DI) is a syndrome characterized by the excretion of abnormally large volumes of dilute urine. It can be caused by any of 4 fundamentally different defects that must be distinguished for safe and effective management. They are: (1) pituitary DI also called neurogenic or central DI, due to inadequate production and secretion of antidiuretic hormone, arginine-vasopressin (AVP); (2) gestational DI due to degradation of arginine vasopressin by an enzyme made in placenta; (3) primary polydipsia, due to suppression of arginine vasopressin secretion by excessive fluid intake; and (4) nephrogenic DI due to renal insensitivity to the antidiuretic effect of AVP. Patients with DI typically present with excessive day and nighttime urination, excessive drinking of fluids in order to compensate for the lost fluids in urine which may lead to electrolyte imbalances such as hypo- or hypernatremia. The causes of Diabetes insipidus are unique to the type of the diabetes insipidus caused, and the treatment should be targeted at understanding the underlying cause of the disease.
-Diabetes insipidus (DI) is a rare disease that causes [[frequent urination]]. The large volume of urine is diluted, mostly water. To make up for lost water, a person with DI may feel the need to drink large amounts and is likely to urinate frequently, even at night, which can disrupt sleep and, on occasion, cause [[bedwetting]]. Because of the excretion of abnormally large volumes of dilute urine, people with DI may quickly become dehydrated if they do not drink enough water. Children with DI may be irritable or listless and may have [[fever]], [[vomiting]], or [[diarrhea]]. Milder forms of DI can be managed by drinking enough water, usually between 2 and 2.5 liters a day. DI severe enough to endanger a person’s health is rare.
 ==Historical Perspective==