This is a state of the body in which a large amount of fluid is excreted in the form of urine because the kidneys are unable to concentrate urine normally, and a large amount of dilute urine is excreted (polyuria: more than 3 litres/day).
If the cause is a disorder in the production or release of the hormone that concentrates urine, the antidiuretic or vasopressin hormone, it is called central diabetes insipidus. The most common causes are: brain surgery, trauma, tumours, infections and sarcoidosis. If the disorder is in the kidneys, because they are unable to respond to the diuretic hormone produced by the brain, it is called nephrogenic diabetes insipidus.
Symptoms include excessive urine production (more than 3 litres/day) and a marked increase in thirst.
Diagnosis is made by clinical interview, physical examination, blood and urine tests. A fluid deprivation test should be carried out to confirm the inability to concentrate urine.
Treatment aims to treat the underlying cause. If the cause is central, hormones are given as a nasal spray, tablets or intravenously several times a day. If the cause is kidney related, the most common drug treatment is thiazides.
- Daniel G Bichet. Diagnosis of polyuria and diabetes insipidus. UptoDate, Septiembre 2015
- Daniel G Bichet. Treatment of central diabetes insipidus. Enero 2016
- Mavrakis AN. Diabetes insipidus with deficient thirst: report of a patient and review of the literature. Am J Kidney Dis 2008; 51:851.
- Achinger SG. Desmopressin acetate (DDAVP)-associated hyponatremia and brain damage: a case series. Nephrol Dial Transplant 2014; 29:2310.
- Shlomo Melmed. Hipopituitarismo. Harrison. Principios de Medicina Interna, 19e. Capítulo 402.
- J. M. Gómez Sáez. Enfermedades de la neurohipófisis. Farreras Rozman. Medicina Interna, ed 18. Capítulo 229
