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Neurogenic Diabetes Insipidus Symptoms

Central Diabetes Insipidus

Central Diabetes Insipidus

Central diabetes insipidus (DI) is a form of DI that occurs when the body has lower than normal levels of antidiuretic hormone (vasopressin), which is characterized by frequent urination.[1][2] Diabetes insipidus is subdivided into central and nephrogenic DI. Two other forms are gestational DI and primary polydipsia (dipsogenic DI). Central DI results from damage to the pituitary gland, which disrupts the normal storage and release of antidiuretic hormone (ADH). When this hormone reaches the kidneys, it directs them to make less urine. The major symptoms of central diabetes insipidus (DI) include urinating too much (polyuria), getting up at night to urinate (nocturia), and drinking too much liquids (polydipsia). Damage to the pituitary gland can be caused by different diseases as well as by head injuries, neurosurgery, or genetic disorders.[2] The three main options for the treatment of central DI include a synthetic hormone called desmopressin, which can be taken by as an injection, a nasal spray, or a pill; other drugs, such as chlorpropamide, carbamazepine, thiazide diuretics, and nonsteroidal anti-inflammatory drugs; and a low-solute (mostly low-sodium, low-protein) diet.[3] Continue reading >>

Neurogenic Diabetes Insipidus Causes, Symptoms, Treatments

Neurogenic Diabetes Insipidus Causes, Symptoms, Treatments

Neurogenic Diabetes Insipidus Causes, Symptoms, Treatments Neurogenic diabetes insipidus is also known as central diabetes insipidus and is the most common type of this disease. Symptoms are causes by the lack of a hormone that normally acts upon the kidneys to reduce urine output, this results in symptoms that include excessive urination. Neurogenic diabetes insipidus (DI) is caused by a decrease in the production, storage or delivery of antidiuretic hormone (ADH), also know as arginine vasopressin (AVP). This hormone's job is to limit the amount of urine produced by causing less water to be lost through urination. ADH is produced in the hypothalamus of the brain and stored in the pituitary gland until needed. In neurogenic DI, ADH is not available in sufficient amounts. This lack of ADH " may be caused by damage to the hypothalamus or pituitary gland. This damage may be related to surgery, infection, inflammation, tumor, or injury to the head "(1). In some cases the cause is unknown and in rare cases a genetic defect may be at fault. The need to get out of bed frequently during the night to urinate or accidental bedwetting Neurogenic diabetes insipidus diagnosis and treatment You should consult with your doctor if any of the symptoms of diabetes insipidus are noticed. The disease is diagnosed by the following tests: Urinalysis may be performed to determine if signs of neurogenic DI are present such as dilute urine with a low specific gravity or osmolarity. A water restriction test may be performed to reveal how well the kidneys are performing and how much urine is being produced. A CT or MRI of the head may be performed to reveal any problems involving the pituitary gland. Treatment and outcome will depend on the underlying condition that caused the diabetes insipidu Continue reading >>

Diabetes Insipidus

Diabetes Insipidus

Diabetes insipidus (DI) 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] There are four types of DI, each with a different set of causes.[1] Central DI (CDI) is due to a lack of the hormone vasopressin (antidiuretic hormone).[1] This can be due to damage to the hypothalamus or pituitary gland or genetics.[1] Nephrogenic diabetes insipidus (NDI) occurs when the kidneys do not respond properly to vasopressin.[1] Dipsogenic DI is due to abnormal thirst mechanisms in the hypothalamus while gestational DI occurs only during pregnancy.[1] Diagnosis is often based on urine tests, blood tests, and the fluid deprivation test.[1] Diabetes mellitus is a separate condition with an unrelated 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 disease treated is with desmopressin.[1] Nephrogenic disease may be treated by addressing the underlying cause or 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.[5] Signs and symptoms[edit] Excessive urination and extreme thirst and increased fluid intake (especially for cold water and sometimes ice or ice water) are typical for DI.[6] The symptoms of excessive urination Continue reading >>

Diabetes Insipidus: Causes & Symptoms + 5 Natural Treatments

Diabetes Insipidus: Causes & Symptoms + 5 Natural Treatments

Diabetes insipidus, is a debilitating and rare disease, with a prevalence of 1 out of 25,000 people. Often referred to as “water diabetes,” it is a condition characterized by frequent and heavy urination, excessive thirst and an overall feeling of weakness. It’s caused by a defect in the pituitary gland or in the kidneys. (1) The term insipidus means “without taste” in Latin, while diabetes mellitus involves the excretion of “sweet” urine. People with diabetes insipidus pass urine that is diluted, odorless and relatively low in sodium content. Diabetes insipidus and diabetes mellitus (which includes both type 1 and type 2 diabetes) are unrelated. Both conditions do cause frequent urination and constant thirst. People with diabetes insipidus have normal blood sugar levels, but their kidneys cannot balance fluid in the body. Although the symptoms of diabetes insipidus can be bothersome and sometimes even life-changing, the condition doesn’t increase future health risks when it is managed properly. It’s important to find the right treatment plan, which typically involves taking measures to avoid dehydration. What is Diabetes Insipidus? Diabetes insipidus is a condition that disrupts normal life due to increased thirst and passing of large volumes or urine, even at night. It is a part of a group of hereditary or acquired polyuria (when large amounts of urine is produced) and polydipsia (excessive thirst) diseases. It’s associated with inadequate vasopressin or antidiuretic hormone secretion. Vasopressin, which includes arginine vasopressin (AVP) and antidiuretic hormone (ADH), is a peptide hormone formed in the hypothalamus. It then travels to the posterior pituitary where it releases into the blood. In order to fully understand the cause of diabetes ins Continue reading >>

Diabetes Insipidus: Causes, Symptoms And Treatment

Diabetes Insipidus: Causes, Symptoms And Treatment

Diabetes insipidus is a condition where the body loses too much fluid through urination, causing a significant risk of dangerous dehydration as well as a range of illnesses and conditions. There are two forms of the disease: nephrogenic diabetes insipidus and central diabetes insipidus (also known as neurogenic diabetes insipidus). A number of factors have been linked to the development of diabetes insipidus, which may also occur in pregnancy or with the use of certain medications. Establishing the cause of the problem can help determine the most appropriate treatment to support the regulation of water balance in the body. Diabetes insipidus is a condition that can be managed successfully. Contents of this article: What is diabetes insipidus? An uncommon condition, diabetes insipidus is a disorder affecting the regulation of body fluid levels. Two key symptoms resemble those of the more common forms of diabetes that affect blood sugar levels (diabetes mellitus types 1 and 2).1-5 People with diabetes insipidus produce excessive amounts of urine (polyuria), resulting in frequent urination and, in turn, thirst (polydipsia). However, the underlying cause of these two symptoms is quite different from the causes in types 1 and 2 diabetes. In diabetes mellitus, elevated blood sugar prompts the production of large volumes of urine to help remove the excess sugar from the body. In diabetes insipidus, it is the body's water balance system itself that is not working properly. Here are some key points about diabetes insipidus. More detail and supporting information is in the body of this article. Diabetes insipidus is a condition where the body fails to properly control water balance, resulting in excessive urination. Diabetes insipidus can be caused by low or absent secretion of t Continue reading >>

Central Diabetes Insipidus

Central Diabetes Insipidus

(Vasopressin-Sensitive Diabetes Insipidus) By Ian M. Chapman, MBBS, PhD, Professor of Medicine, Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital Central diabetes insipidus is a lack of the hormone vasopressin (antidiuretic hormone) that causes excessive production of very dilute urine (polyuria). Central diabetes insipidus has several causes, including a brain tumor, a brain injury, brain surgery, tuberculosis, and some forms of other diseases. The diagnosis is based on urine tests, blood tests, and a water deprivation test. Vasopressin is a hormone produced by the hypothalamus (a region of the brain that lies just above the pituitary) and stored in and released from the posterior lobe of the pituitary gland. Vasopressin helps regulate the amount of water in the body by signalling the kidneys to decrease the amount of urine they produce (see About Body Water). Because a diuretic is a substance that increases urine production, vasopressin previously was referred to as antidiuretic hormone. Causes Other disorders that can cause central diabetes insipidus include accidental damage done during surgery on the hypothalamus or pituitary gland; a brain injury, particularly a fracture of the base of the skull; a tumor; sarcoidosis or tuberculosis; an aneurysm (a bulge in the wall of an artery) or blockage in the arteries leading to the brain; some forms of encephalitis or meningitis; and the rare disease Langerhans cell histiocytosis. Nephrogenic diabetes insipidus is another type of diabetes insipidus in which there is an adequate amount of vasopressin, but abnormalities in the kidneys cause them not to respond to vasopressin. Symptoms Diagnosis Doctors suspect diabetes insipidus in people who produce large amounts of urine. They first test the urine for Continue reading >>

Clinical Manifestations And Causes Of Central Diabetes Insipidus

Clinical Manifestations And Causes Of Central Diabetes Insipidus

INTRODUCTION Central diabetes insipidus (CDI) is characterized by decreased release of antidiuretic hormone (ADH, also called arginine vasopressin or AVP), resulting in a variable degree of polyuria. Lack of ADH can be caused by disorders that act at one or more of the sites involved in ADH secretion: the hypothalamic osmoreceptors; the supraoptic or paraventricular nuclei; or the superior portion of the supraopticohypophyseal tract [1]. By contrast, damage to the tract below the median eminence or to the posterior pituitary generally causes only transient polyuria, because ADH produced in the hypothalamus can still be secreted into the systemic circulation via the portal capillaries in the median eminence [1]. (See "Hypothalamic-pituitary axis".) The clinical manifestations and causes of CDI will be reviewed here. The treatment of CDI, the clinical manifestations and causes of nephrogenic diabetes insipidus (DI), and the diagnostic approach to the polyuric patient are discussed separately. (See "Treatment of central diabetes insipidus" and "Clinical manifestations and causes of nephrogenic diabetes insipidus" and "Diagnosis of polyuria and diabetes insipidus".) CLINICAL MANIFESTATIONS Patients with untreated central diabetes insipidus (CDI) typically present with polyuria, nocturia, and, due to the initial elevation in serum sodium and osmolality, polydipsia. They may also have neurologic symptoms related to the underlying neurologic disease. The serum sodium concentration in untreated CDI is often in the high normal range, which is required to provide the ongoing stimulation of thirst to replace the urinary water losses. Moderate to severe hypernatremia can develop when thirst is impaired or cannot be expressed. This can occur in patients with central nervous system l Continue reading >>

Diabetes Insipidus: Practice Essentials, Background, Etiology

Diabetes Insipidus: Practice Essentials, Background, Etiology

Diabetes insipidus (DI) is defined as the passage of large volumes (>3 L/24 hr) of dilute urine (< 300 mOsm/kg). It has the following 2 major forms: Central (neurogenic, pituitary, or neurohypophyseal) DI, characterized by decreased secretion of antidiuretic hormone (ADH; also referred to as arginine vasopressin [AVP]) Nephrogenic DI, characterized by decreased ability to concentrate urine because of resistance to ADH action in the kidney [ 1 ] Two other forms are gestational DI and primary polydipsia (dipsogenic DI); both are caused by deficiencies in AVP, but the deficiencies do not result from a defect in the neurohypophysis or kidneys. The predominant manifestations of DI are as follows: Polyuria: The daily urine volume is relatively constant for each patient but is highly variable between patients (3-20 L) The most common form is central DI after trauma or surgery to the region of the pituitary and hypothalamus, which may exhibit 1 of the following 3 patterns: Earley LE, Orloff J. The mechanism of antidiuresis associated with the administration of hydrochlorothiazide to patients with vasopressin-resistant diabetes insipidus. J Clin Invest. Nov 1962;41(11):1988-97. Babey M, Kopp P, Robertson GL. Familial forms of diabetes insipidus: clinical and molecular characteristics. Nat Rev Endocrinol. 2011 Jul 5. 7(12):701-14. [Medline] . Bockenhauer D, van't Hoff W, Dattani M, Lehnhardt A, Subtirelu M, Hildebrandt F, et al. Secondary nephrogenic diabetes insipidus as a complication of inherited renal diseases. Nephron Physiol. 2010. 116(4):p23-9. [Medline] . Los EL, Deen PM, Robben JH. Potential of nonpeptide (ant)agonists to rescue vasopressin V2 receptor mutants for the treatment of X-linked nephrogenic diabetes insipidus. J Neuroendocrinol. 2010 May. 22(5):393-9. [Medlin Continue reading >>

Central Diabetes Insipidus

Central Diabetes Insipidus

is completely unrelated to diabetes, even though they share the symptoms of peeing more and feeling thirsty. It's also called "central DI," "pituitary DI," "hypothalamic DI," "neurohypophyseal DI," or "neurogenic DI." Central DI is much less common than diabetes, and treatments for the two diseases are different. The key sign of central diabetes insipidus is extreme thirst and excessive urination. The disease happens when the body doesn't make enough of the hormone vasopressin, which controls how much urine the kidneys put out. Without vasopressin, the kidneys can't work properly. As a result, the body loses a lot of water, quickly, in diluted urine. This makes people very thirsty, so they drink lots of water. Anyone can get central DI, but it's not common. Only about 1 in every 25,000 people gets it. In about half the cases, doctors don't know what causes central DI. Other times, it happens because of damage or injury to the hypothalamus or pituitary gland. This damage can be due to surgery, head trauma, tumor, inflammation, or infection. In very rare cases, genetic defects are the cause. Prompt treatment of injuries, infections, and tumors can lower the odds of getting the disease. People with central DI usually have the following symptoms: Frequent urination -- more than 3 liters of urine a day Frequent nighttime awakening to pee Involuntary urination during sleep (bed-wetting) Pale, colorless urine Low measured concentration of urine Extreme thirst -- often drinking more than 1 gallon of liquid per day In severe cases, or if a person can't get enough liquid to drink, central diabetes insipidus can cause: Confusion Loss of consciousness Symptoms of central DI in children may be: Low energy Irritability Slow growth Fever A checkup may not show any signs of central DI, Continue reading >>

Diabetes Insipidus

Diabetes Insipidus

Print Overview Diabetes insipidus (die-uh-BEE-teze in-SIP-uh-dus) is an uncommon disorder that causes an imbalance of water in the body. This imbalance leads to intense thirst even after drinking fluids (polydipsia), and excretion of large amounts of urine (polyuria). While the names diabetes insipidus and diabetes mellitus sound similar, they're not related. Diabetes mellitus — which can occur as type 1 or type 2 — is the more common form of diabetes. There's no cure for diabetes insipidus, but treatments are available to relieve your thirst and normalize your urine output. Symptoms The most common signs and symptoms of diabetes insipidus are: Extreme thirst Excretion of an excessive amount of diluted urine Depending on the severity of the condition, urine output can be as much as 16 quarts (about 15 liters) a day if you're drinking a lot of fluids. Normally, a healthy adult will urinate an average of less than 3 quarts (about 3 liters) a day. Other signs may include needing to get up at night to urinate (nocturia) and bed-wetting. Infants and young children who have diabetes insipidus may have the following signs and symptoms: Unexplained fussiness or inconsolable crying Trouble sleeping Fever Vomiting Diarrhea Delayed growth Weight loss When to see a doctor See your doctor immediately if you notice the two most common signs of diabetes insipidus: excessive urination and extreme thirst. Causes Diabetes insipidus occurs when your body can't regulate how it handles fluids. Normally, your kidneys remove excess body fluids from your bloodstream. This fluid waste is temporarily stored in your bladder as urine, before you urinate. When your fluid regulation system is working properly, your kidneys conserve fluid and make less urine when your body water is decreased, suc Continue reading >>

Ucla Pituitary Tumor Program

Ucla Pituitary Tumor Program

Diabetes insipidus (DI) is an abnormal condition characterized by the inability of the kidneys to conserve water. This leads to excessive thirst and a high volume of urine. The most common cause is the lack of a pituitary hormone called antidiuretic hormone (ADH). In less common cases, ADH is present, but the kidneys do not respond to it. Diabetes Insipidus: Expert Care in Southern California The UCLA Pituitary Tumor Program offers comprehensive management of pituitary insufficiency. Our physicians have years of experience in diagnosing, treating and managing pituitary conditions. We use the most sophisticated diagnostic equipment and monitor your progress carefully during treatment and recovery. Learn more about diabetes insipidus: The primary job of ADH is to restrict the amount of water in the urine, making the urine more concentrated. In patients with diabetes insipidus, the urine is very diluted. There are many causes of central (pituitary) diabetes insipidus, including: Congenital absence of the gland Lesions that involve or destroy the pituitary stalk and/or posterior pituitary gland Lymphocytic hypophysitis Sarcoid Germinoma Tuberculosis Other granulomatous diseases Tumors of the posterior pituitary gland Pituitary gangliocytoma Injury to the posterior pituitary gland or pituitary stalk following surgery to that area of the brain Patients with diabetes insipidus typically experience: Excessive thirst, particularly for ice cold water Excessive urination of dilute urine If the brain's thirst mechanism is working normally, a person with diabetes insipidus will drink large volumes of water to maintain a normal serum concentration. However, failure or inability to drink enough water to keep up with the water lost in the urine results in severe dehydration. Symptoms c Continue reading >>

Central Diabetes Insipidus

Central Diabetes Insipidus

In CDI, symptoms may develop over time or abruptly and may affect individuals of any age. CDI is characterized by excessive thirst (polydipsia) and excessive urination (polyuria), even at night (nocturia). The severity and progression of CDI varies from case to case. Some individuals may have a severe form of the disorder (complete CDI) with little or no vasopressin activity. Others may have a mild form of the disorder (partial CDI) with residual vasopressin activity. Without appropriate AVP secretion, individuals with central diabetes insipidus are unable to concentrate the urine by reabsorbing water in the kidneys. This results in obligatory excessive urine output of dilute urine. Consequently, individuals must drink excessively to prevent dehydration. In response to thirst, affected individuals may drink several gallons of water a day. If affected individuals are deprived of water for an extended period of time, rapid dehydration will occur. Thirst cravings can be strong enough to awaken people from sleep. In infants, additional symptoms may occur including irritability, lethargy, vomiting, constipation and fever. If left untreated, repeated episodes of dehydration can potentially result in seizures, brain damage, developmental delays, and physical and mental retardation. However, with proper diagnosis and prompt treatment intelligence and development is usually normal unless more global problems in development of the brain are associated. Affected children may develop bedwetting (enuresis), fatigue, weight loss, and growth retardation. Individuals with CDI are at risk of developing dehydration and cardiovascular symptoms including irregular heartbeats, fever, dry skin and mucous membranes, confusion, seizures, change in consciousness, and potentially coma. Affected Continue reading >>

Diabetes Insipidus

Diabetes Insipidus

What are the types of diabetes insipidus? Central Diabetes Insipidus The most common form of serious diabetes insipidus, central diabetes insipidus, results from damage to the pituitary gland, which disrupts the normal storage and release of ADH. Damage to the pituitary gland can be caused by different diseases as well as by head injuries, neurosurgery, or genetic disorders. To treat the ADH deficiency that results from any kind of damage to the hypothalamus or pituitary, a synthetic hormone called desmopressin can be taken by an injection, a nasal spray, or a pill. While taking desmopressin, a person should drink fluids only when thirsty and not at other times. The drug prevents water excretion, and water can build up now that the kidneys are making less urine and are less responsive to changes in body fluids. Nephrogenic Diabetes Insipidus Nephrogenic diabetes insipidus results when the kidneys are unable to respond to ADH. The kidneys' ability to respond to ADH can be impaired by drugs-like lithium, for example-and by chronic disorders including polycystic kidney disease, sickle cell disease, kidney failure, partial blockage of the ureters, and inherited genetic disorders. Sometimes the cause of nephrogenic diabetes insipidus is never discovered. Desmopressin will not work for this form of diabetes insipidus. Instead, a person with nephrogenic diabetes insipidus may be given hydrochlorothiazide (HCTZ) or indomethacin. HCTZ is sometimes combined with another drug called amiloride. The combination of HCTZ and amiloride is sold under the brand name Moduretic. Again, with this combination of drugs, one should drink fluids only when thirsty and not at other times. Dipsogenic Diabetes insipidus Dipsogenic diabetes insipidus is caused by a defect in or damage to the thirst Continue reading >>

Diabetes Insipidus

Diabetes Insipidus

Diabetes insipidus is a condition in which your ability to control the balance of water within your body is not working properly. Your kidneys are not able to retain water and this causes you to pass large amounts of urine. Because of this, you become more thirsty and want to drink more. There are two different types of diabetes insipidus: cranial and nephrogenic. Cranial diabetes insipidus may only be a short-term problem in some cases. Treatment includes drinking plenty of fluids so that you do not become lacking in fluid in the body (dehydrated). Treatment with medicines may also be needed for both types of diabetes insipidus. A note about thirst and water balance in your body Getting the balance right between how much water your body takes in and how much water your body passes out is very important. This is because a large proportion (about 70%) of your body is actually water. Also, water levels in your body help to control the levels of some important salts, particularly sodium and potassium. Your body normally controls (regulates) water balance in two main ways: By making you feel thirsty and so encouraging you to drink and take more water in. Through the action of a chemical (hormone) called antidiuretic hormone (ADH) which controls the amount of water passed out in your urine. ADH is also known as vasopressin. It is made in a part of your brain called the hypothalamus. It is then transported to another part of your brain, the pituitary gland, from where it is released into your bloodstream. After its release, ADH has an effect on your kidneys. It causes your kidneys to pass out less water in your urine (your urine becomes more concentrated). So, if your body is lacking in fluid (dehydrated), your thirst sensation will be triggered, encouraging you to drink. As Continue reading >>

Diabetes Insipidus - Central

Diabetes Insipidus - Central

Diabetes insipidus (DI) is an uncommon condition in which the kidneys are unable to prevent the excretion of water. Diabetes insipidus is a different disease than diabetes, though both share common symptoms excessive urination and thirst. Central diabetes insipidus is a form of DI that occurs when the body has a lower than normal amount of antidiuretic hormone (ADH). ADH is also called vasopressin. ADH is produced in a part of the brain called the hypothalamus. It is then stored and released from the pituitary gland. This is a small gland at the base of the brain. ADH controls the amount of water excreted in urine. Without ADH, the kidneys do not work properly to keep enough water in the body. The result is a rapid loss of water from the body in the form of dilute urine. This results in the need to drink large amounts of water due to extreme thirst and to make up for excessive water loss in the urine (as much as 4 gallons or 15 liters a day). The reduced level of ADH may be caused by damage to the hypothalamus or pituitary gland. This damage may be due to surgery, infection, inflammation, tumor, or injury to the brain. Sometimes the cause is unknown. In rare cases, central diabetes insipidus is caused by a genetic problem. Continue reading >>

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