Diabetes insipidus medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
The hallmark symptoms of both central and nephrogenic diabetes insipidus (DI) are polyuria, nocturia, and polydipsia due to the concentrating defect. Treatment of central DI is primarily aimed at decreasing the urine output, usually by increasing the activity of antidiuretic hormone (ADH, also called arginine vasopressin or AVP). | |||
However, nephrogenic diabetes insipidus (DI) results from resistance of the kidney to the actions of antidiuretic hormone(ADH). As a result, patients with this disorder are not likely to have a good response to hormone administration (as dDAVP) or to drugs that increase either the renal response to ADH or ADH secretion and so other treatment options must be explored. | |||
==Medical Therapy== | ==Medical Therapy== | ||
Central DI and gestational DI respond to [[desmopressin]]. In dipsogenic DI, [[desmopressin]] is not usually an option. [[Desmopressin]] will be ineffective in nephrogenic DI. Instead, the [[diuretic]] [[hydrochlorothiazide]] (HCT or HCTZ) or [[indomethacin]] can improve NDI; HCT is sometimes combined with [[amiloride]] to prevent [[hypokalemia]]. Again, adequate hydration is important for patients with DI, as they may become dehydrated easily. | Central DI and gestational DI respond to [[desmopressin]]. In dipsogenic DI, [[desmopressin]] is not usually an option. [[Desmopressin]] will be ineffective in nephrogenic DI. Instead, the [[diuretic]] [[hydrochlorothiazide]] (HCT or HCTZ) or [[indomethacin]] can improve NDI; HCT is sometimes combined with [[amiloride]] to prevent [[hypokalemia]]. Again, adequate hydration is important for patients with DI, as they may become dehydrated easily. | ||
Revision as of 15:52, 12 July 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The hallmark symptoms of both central and nephrogenic diabetes insipidus (DI) are polyuria, nocturia, and polydipsia due to the concentrating defect. Treatment of central DI is primarily aimed at decreasing the urine output, usually by increasing the activity of antidiuretic hormone (ADH, also called arginine vasopressin or AVP). However, nephrogenic diabetes insipidus (DI) results from resistance of the kidney to the actions of antidiuretic hormone(ADH). As a result, patients with this disorder are not likely to have a good response to hormone administration (as dDAVP) or to drugs that increase either the renal response to ADH or ADH secretion and so other treatment options must be explored.
Medical Therapy
Central DI and gestational DI respond to desmopressin. In dipsogenic DI, desmopressin is not usually an option. Desmopressin will be ineffective in nephrogenic DI. Instead, the diuretic hydrochlorothiazide (HCT or HCTZ) or indomethacin can improve NDI; HCT is sometimes combined with amiloride to prevent hypokalemia. Again, adequate hydration is important for patients with DI, as they may become dehydrated easily.