Nephrology Book

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Diabetes Insipidus

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  1. Subtypes
    1. Central Diabetes Insipidus
    2. Nephrogenic Diabetes Insipidus (most common)
  2. Pathophysiology
    1. Excessive constant water diuresis due to:
      1. Central Anti-Diuretic Hormone deficiency (ADH) or
      2. Lack of renal response to Anti-Diuretic Hormone
  3. Symptoms
    1. Polyuria
    2. Polydipsia
      1. Unquenchable thirst
  4. Differential Diagnosis
    1. Psychogenic polydipsia
  5. Labs
    1. Serum Osmolality
      1. Increased in both Nephrogenic DI and Central DI
    2. Urinalysis
      1. Urine Specific Gravity under 1.008
  6. Diagnosis
    1. Fluid Deprivation Test
      1. Water deprivation
        1. No response in Nephrogenic DI or Central DI
      2. Exogenous ADH administration
        1. Corrects Central DI
        2. Does not correct Nephrogenic DI
    2. Hare-Hickey Test
      1. Fluid restriction or Injection of hypertonic saline
      2. Measure ADH to Serum Osmolality ratio
        1. Decreased ratio in Central Diabetes Insipidus
        2. Increased ratio in Nephrogenic Diabetes Insipidus
  7. Management
    1. Central Diabetes Insipidus
      1. See Central Diabetes Insipidus
    2. Nephrogenic Diabetes Insipidus
      1. Remove provocative factors

Diabetes Insipidus (C0011848)

Definition (MSH)A disease that is characterized by frequent urination, excretion of large amounts of dilute URINE, and excessive THIRST. Etiologies of diabetes insipidus include deficiency of ANTIDIURETIC HORMONE (also known as ADH or VASOPRESSIN) secreted by the NEUROHYPOPHYSIS, impaired KIDNEY response to ADH, and impaired hypothalamic regulation of thirst.
Definition (CSP)metabolic disorder due to injury of the neurohypophyseal system; results in deficient quanity of antidiuretic hormone being released or produced, failure of tubular reabsorption of water in the kidney.
ConceptsDisease or Syndrome (T047)
ICD9253.5
MSHD003919
EnglishDI - Diabetes insipidus, Diabetes Insipidus
Spanishdiabetes insipida
Parent ConceptsHypopituitarism (C0020635), Inappropriate ADH Syndrome (C0021141), Posterior pituitary disease (C0751438), Disorder of pituitary gland and its hypothalamic control (C0859058), Kidney Diseases (C0022658), Pituitary Diseases (C0032002), Non-Neoplastic Endocrine Disorder (C1335007), Metabolic Diseases (C0025517), Metabolic disorder of transport (C1263737)
SourcesCOSTAR, CSP, CST, DXP, ICD9CM, MEDLINEPLUS, MSH, MTH, NCI, NDFRT, OMIM, QMR, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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