Diabetes Insipidus

Diabetes Insipidus (DI) is characterized by the body being unable to properly conserve water. In a normal individual, the kidneys respond to the endocrine system’s output of antidiuretic hormone (ADH), also known as vasopressin, to eliminate excess water while the blood is filtered. In diabetes insipidus, the kidneys eliminate more water than they should, leaving patients constantly thirsty, in danger of electrolyte imbalance and other dehydration-related complications, and urinating more frequently than normal.

Diabetes Insipidus is caused in one of two ways. In some patients, the body does not produce enough ADH, leaving the kidneys without the correct “check” on their diuraetic functions. This is known as “central” diabetes inspidus. In other cases, the kidneys fail to properly reabsorb fluid back into the bloodstream, while the endocrine system is working normally. This is called “nephrogenic” diabetes insipidus.

In central diabetes insipidus, treatment is fairly straightforward. Patients are prescribed vasopressin, usually administered via nasal spray, to replace the ADH their bodies do not produce. Treatment for central diabetes insipidus is usually very sucessful, and petients are generally able to lead near normal lives.

With nephrogenic diabetes insipidus, the prognosis for the patient depends very much on what is causing their kidneys to malfunction in the first place. In some cases, it may be a side effect of certain medications (such as: lithium, demeclocycline or amphotericin B). Doctors may then find an alternate medication to prescribe, or attempt to adjust the patient’s dose to minimise the DI side effect. However, in other cases, nephrogenic diabetes insipidus is caused by damage from a kidney disease, or hereditary factors, and the only option for the patient is to make sure their fluid intake is sufficient to prevent dehydration.

In any case of diabetes insipidus, long term side effects or serious complications are virtually never seen, as long as the patient diligently avoids dehydration.

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