Diabetes insipidus (DI) is an endocrine disorder involving deficient production or lack of effective action of an antidiuretic hormone (ADH or vasopressin). ADH is made in the hypothalamus, stored in and secreted by the pituitary gland and works on the kidney to conserve fluid. Deficient production of ADH or lack of effective action of ADH at the kidney causes large amount of urine output, increasing thirst, dehydration, and low blood pressure in advanced cases. While the average urine volume for a normal adult is 1.5 liters daily, it can approach 18 liters daily in DI.
When diseases of the hypothalamus and pituitary gland cause reduced ADH production, it is called central DI. When diseases of the kidney cause a lack of response to ADH it is called nephrogenic DI.
Examples of central DI include surgical removal of the hypothalamus, tumors of the hypothalamus or the pituitary gland, infection of the pituitary gland, autoimmune damage of the pituitary gland, and familial disease of the pituitary gland.
Examples of nephrogenic DI include certain kidney diseases and can be influenced by low blood potassium level, protein starvation, high blood calcium level, sickle cell anemia and medication use (such as lithium, demeclocycline and methoxyflurane).
Diagnosis of DI involves excluding other conditions producing large urine volumes, lab testing for ADH and other tests to determine the cause.
Treatment of central DI involves administering the missing ADH hormone orally, by injection or by inhalation nasally. Properly treated, patients with central DI can restore urine volume towards normal levels and do well. Long term prognosis of many patients with central DI are good, some actually spontaneously improve over time. To achieve optimal outcome, it is important for patients to work closely with their doctors to accurately diagnose the condition, identify the underlying cause, and start treatment.
Signs, symptoms & indicators of Diabetes Insipidus
Constant thirst
Having a slight/having a moderate/having a high fever
Key
| Weak or unproven link |
Glossary
Diabetes Insipidus
Excessive production of urine, usually due to insufficient production of antidiuretic hormone.
Hormones
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Hypothalamus
An important supervisory center in the brain regulating many body functions. Despite its importance in maintaining homeostasis, the hypothalamus in humans accounts for only 1/300 of total brain weight, and is about the size of an almond.
Pituitary
The pituitary gland is small and bean-shaped, located below the brain in the skull base very near the hypothalamus. Weighing less than one gram, the pituitary gland is often called the "master gland" since it controls the secretion of hormones by other endocrine glands.
Autoimmune Disease
One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.
Potassium
A mineral that serves as an electrolyte and is involved in the balance of fluid within the body. Our bodies contain more than twice as much potassium as sodium (typically 9oz versus 4oz). About 98% of total body potassium is inside our cells. Potassium is the principal cation (positive ion) of the fluid within cells and is important in controlling the activity of the heart, muscles, nervous system and just about every cell in the body. Potassium regulates the water balance and acid-base balance in the blood and tissues. Evidence is showing that potassium is also involved in bone calcification. Potassium is a cofactor in many reactions, especially those involving energy production and muscle building.
Protein
Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.
Calcium
The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. Calcium is also important to heart health, nerves, muscles and skin. Calcium helps control blood acid-alkaline balance, plays a role in cell division, muscle growth and iron utilization, activates certain enzymes, and helps transport nutrients through cell membranes. Calcium also forms a cellular cement called ground substance that helps hold cells and tissues together.
Anemia
A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.