Diabetes insipidus is a condition where the kidneys remove water from the body inappropriately from the circulatory system.
There are two forms of diabetes insipidus (ID):
- Central insipid diabetes (central ID)
- Nephrogenic diabetes insipidus (NDI): due to kidney cells in the kidneys that do not respond to ADH.
The antidiuretic hormone (ADH) controls the amount of water that is reabsorbed by the kidneys. ADH occurs in the hypothalamus of the brain. The pituitary gland, located at the base of the brain, stores and releases ADH. Central DI occurs when the hypothalamus does not produce enough ADH. DIN occurs when the kidney does not respond to ADH.
Some diabetes insipidus are caused by genetic problems that cause DIN or central DI. Others may develop after an injury or illness.
Factors that may increase the risk of diabetes insipidus include:
- Damage to the hypothalamus or pituitary due to surgery, infection, tumor or head injury.
- Certain conditions (eg, sarcoidosis, tuberculosis, granulomatosis with polyangiitis).
- Certain medications (eg, lithium): the most common cause of diabetes insipidus.
- Nephropathy (eg, polycystic kidney disease).
Certain conditions (eg, hypercalcemia, hypokalemia).
Symptoms may include:
- Increased urination, especially during the night.
- Excessive thirst
- Dehydration (increased heart rate, dry skin and mouth).
The doctor will ask about your symptoms and medical history. A physical examination may be performed.
Tests may include:
- Electrolyte levels
- Renal function tests
- ADH levels
- Blood sugar to detect diabetes mellitus
- Gravity or specific urine osmolality (measures how concentrated or diluted the urine is)
- Analysis of urine volume to see how much urine is produced.
Water shortage test
- It is only done under medical supervision
- Urine production measured during a period of 24 hours
- Nuclear magnetic resonance (NMR) of the head: if central ID is suspected.
Ask your doctor what is the best plan for you. The doctor will work with you to treat the underlying cause.
The treatment may include:
- For the central DI: take a synthetic form of ADH
- For DIN: follow a diet low in sodium, drink plenty of water, take a diuretic (water tablet).
There are no known ways to prevent diabetes insipidus. Talk to your doctor right away if you have excessive urination or thirst.