Diabetes insipidus
Condition characterized by large amounts of dilute urine and increased thirst / From Wikipedia, the free encyclopedia
Diabetes insipidus (DI), alternately called arginine vasopressin deficiency (AVP-D) or arginine vasopressin resistance (AVP-R),[5] is a condition characterized by large amounts of dilute urine and increased thirst.[1] The amount of urine produced can be nearly 20 liters per day.[1] Reduction of fluid has little effect on the concentration of the urine.[1] Complications may include dehydration or seizures.[1]
Diabetes insipidus | |
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Vasopressin | |
Pronunciation |
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Specialty | Endocrinology |
Symptoms | Large amounts of dilute urine, increased thirst[1] |
Complications | Dehydration, seizures[1] |
Usual onset | Any age[2][3] |
Types | Central, nephrogenic, dipsogenic, gestational[1] |
Causes | Depends on the type[1] |
Diagnostic method | Urine tests, blood tests, fluid deprivation test[1] |
Differential diagnosis | Diabetes mellitus[1] |
Treatment | Drinking sufficient fluids[1] |
Medication | Desmopressin, thiazides, aspirin[1] |
Prognosis | Good with treatment[1] |
Frequency | 3 per 100,000 per year[4] |
There are four types of DI, each with a different set of causes.[1] Central DI (CDI) is due to a lack of vasopressin (antidiuretic hormone) production.[1] This can be due to injury to the hypothalamus or pituitary gland or genetics.[1] Nephrogenic DI (NDI) occurs when the kidneys do not respond properly to vasopressin.[1] Dipsogenic DI is a result of excessive fluid intake due to damage to the hypothalamic thirst mechanism.[1] It occurs more often in those with certain psychiatric disorders or on certain medications.[1] Gestational DI occurs only during pregnancy.[1] Diagnosis is often based on urine tests, blood tests and the fluid deprivation test.[1] Despite the name, diabetes insipidus is unrelated to diabetes mellitus and the conditions have a distinct mechanism, though both can result in the production of large amounts of urine.[1]
Treatment involves drinking sufficient fluids to prevent dehydration.[1] Other treatments depend on the type.[1] In central and gestational DI, treatment is with desmopressin.[1] Nephrogenic DI may be treated by addressing the underlying cause or by the use of a thiazide, aspirin or ibuprofen.[1] The number of new cases of diabetes insipidus each year is 3 in 100,000.[4] Central DI usually starts between the ages of 10 and 20 and occurs in males and females equally.[2] Nephrogenic DI can begin at any age.[3] The term "diabetes" is derived from the Greek word meaning siphon.[6]