Diabetes insipidus Diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2]
Overview
Diagnostic Study of Choice
Diagnostic approach
| Clinical exam, signs, symptoms | |||||||||||||||||||||||||||||||||||||||
| 24-hrs water balance: •Confirm polyurea and polydipsia | |||||||||||||||||||||||||||||||||||||||
| 24-hrs urine volume: • >50-60 ml/kg (age 0-10) • >40-50 ml/kg (age >10) | |||||||||||||||||||||||||||||||||||||||
| Blood and urine test (Na+, Posm, Uosm) | Other diagnostic hypothesis | ||||||||||||||||||||||||||||||||||||||
• Plasma Na+ >143 mEq/L • Posm >295 mOsm/kg H2O • Uosm < Posm | • Plasma Na+ <143 mEq/L • Posm <295 mOsm/kg H2O • Uosm < Posm | ||||||||||||||||||||||||||||||||||||||
| Water deprivation test (minimum for 7 hrs) • Monitor body wt, Posm, Uosm, plasma AVP • Inturrept and measure AVP/Copeptin if; • >3-5% body wt loss • Plasma Na+ > 143 mEq/L • Posm >295 mOsm/kg H2O • Uosm increases to normal | |||||||||||||||||||||||||||||||||||||||
| Uosm < Posm | Uosm > Posm | ||||||||||||||||||||||||||||||||||||||
| Partial DI | Primary polydipsia | ||||||||||||||||||||||||||||||||||||||
| Desmopressin challange test | |||||||||||||||||||||||||||||||||||||||