Diabetes insipidus overview
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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) Central DI also called neurogenic DI, due to inadequate production and secretion of antidiuretic hormone, arginine-vasopressin (AVP); (2) Nephrogenic DI due to renal insensitivity to the antidiuretic effect of AVP (3) Primary polydipsia, due to suppression of arginine vasopressin secretion by excessive fluid intake and (4)Gestational DI due to degradation of arginine vasopressin by an enzyme made in placenta. 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
Diabetes Insipidus can be classified into central and nephrogenic diabetes insipidus based on the response of the body to administration of desmopressin (DDAVP). It can also be classified based on the body's response to desmopressin (DDAVP) and the levels of hypo- or hypernatremia.