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What Leads To Diabetes Insipidus?

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: 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 >>

What Is Diabetes Insipidus?

What Is Diabetes Insipidus?

Diabetes insipidus is a condition that results from insufficient production of the antidiuretic hormone (ADH), a hormone that helps the kidneys and body conserve the correct amount of water. Normally, the antidiuretic hormone controls the kidneys' output of urine. It is secreted by the hypothalamus (a small gland located at the base of the brain), stored in the pituitary gland, and then released into the bloodstream. ADH is secreted to decrease the amount of urine output so that dehydration does not occur. Diabetes insipidus, however, causes excessive production of very diluted urine and excessive thirst. The disease is categorized into groups: Central diabetes insipidus. An insufficient production or secretion of ADH; can be a result of damage to the hypothalamus or pituitary gland caused by head injuries, genetic disorders, and other diseases. Nephrogenic diabetes insipidus. A lack of kidney response to normal levels of ADH: can be caused by drugs or chronic disorders, such as kidney failure, sickle cell disease, or polycystic kidney disease. What causes diabetes insipidus? Diabetes insipidus can be caused by several conditions, including the following: Malfunctioning hypothalamus (that produces too little ADH) Malfunctioning pituitary gland (that fails to release ADH into the bloodstream) Damage to hypothalamus or pituitary gland during surgery Brain injury Tumor Blockage in the arteries leading to the brain Encephalitis (inflammation of the brain) Meningitis (inflammation of the meninges, the membranes that cover the brain and spinal cord) Sarcoidosis (a rare inflammation of the lymph nodes and other tissues throughout the body) Family heredity What are the symptoms of diabetes insipidus? The following are the most common symptoms of diabetes insipidus. However, eac Continue reading >>

Causes

Causes

Diabetes insipidus is caused by problems with a chemical called vasopressin (AVP), which is also known as antidiuretic hormone (ADH) . AVP is produced by the hypothalamus and stored in the pituitary gland until needed. The hypothalamus is an area of the brain that controls mood and appetite. The pituitary gland is located below your brain, behind the bridge of your nose. AVP regulates the level of water in your body by controlling the amount of urine your kidneys produce. When the level of water in your body decreases, your pituitary gland releases AVP to conserve water and stop the production of urine. In diabetes insipidus, AVP fails to properly regulate your body's level of water, and allows too much urine to be produced and passed from your body. There are two main types of diabetes insipidus: cranial diabetes insipidus – where the body doesn't produce enough AVP, so excessive amounts of water are lost in large amounts of urine nephrogenic diabetes insipidus – where AVP is produced at the right levels but, for a variety of reasons, the kidneys don't respond to it in the normal way. Possible underlying causes for both types of diabetes insipidus are described below. Cranial diabetes insipidus The three most common causes of cranial diabetes insipidus are: a brain tumour that damages the hypothalamus or pituitary gland a severe head injury that damages the hypothalamus or pituitary gland complications that occur during brain or pituitary surgery No cause can be found for about a third of all cases of cranial diabetes insipidus. These cases, known as idiopathic, appear to be related to the immune system attacking the normal, healthy cells producing AVP. It's unclear what causes the immune system to do this. Less common causes of cranial diabetic insipidus include: Continue reading >>

Nephrogenic Diabetes Insipidus

Nephrogenic Diabetes Insipidus

In nephrogenic diabetes insipidus, the kidneys produce a large volume of dilute urine because the kidney tubules fail to respond to vasopressin (antidiuretic hormone) and are unable to reabsorb filtered water back into the body. Often nephrogenic diabetes insipidus is hereditary, but it can be caused by drugs or disorders that affect the kidneys. To treat nephrogenic diabetes insipidus, people restrict salt in their diet and sometimes take drugs to reduce the amount of urine excreted. Both diabetes insipidus and the better-known type of diabetes, diabetes mellitus, result in the excretion of large volumes of urine. Otherwise, the two types of diabetes are very different. Two types of diabetes insipidus exist. Nephrogenic diabetes insipidus and diabetes mellitus are very different, except that both cause people to excrete large amounts of urine. Causes Normally, the kidneys adjust the concentration and amount of urine according to the body’s needs. The kidneys make this adjustment in response to the level of vasopressin in the blood. Vasopressin, which is secreted by the pituitary gland, signals the kidneys to conserve water and concentrate the urine. In nephrogenic diabetes insipidus, the kidneys fail to respond to the signal. Nephrogenic diabetes insipidus may be Hereditary nephrogenic diabetes insipidus In hereditary nephrogenic diabetes insipidus, the gene that typically causes the disorder is recessive and carried on the X chromosome, one of the two sex chromosomes, so usually only males develop symptoms. However, females who carry the gene can transmit the disease to their sons. Rarely, another abnormal gene can cause nephrogenic insipidus in both males and females. Acquired nephrogenic diabetes insipidus Symptoms People may pass from 1 to 6 gallons (3 to 20 lite 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 >>

What Causes Diabetes Insipidus

What Causes Diabetes Insipidus

Diabetes Insipidus (DI) may not necessarily be a life-threatening condition, but it can create negative life impacts if it is not properly treated. Often causing people to thirst more than normal, those with this disease find themselves drinking water more often and then urinating more frequently. What causes diabetes insipidus? The answer to that question depends on the type of DI that has been diagnosed. Sometimes this disease is passed along from parent to child. At other times, lifestyle habits may contribute to the condition. In up to 30% of cases, there isn’t a known medical cause for DI development. Here is a look at the four different types of diabetes insipidus and what the common causes for the condition typically are. Central Diabetes Insipidus Is Caused By Hormonal Loss There is a hormone that is called Vasopressin that tells the kidneys when they need to absorb water or when they need to retain it. Vasopressin is what is known as an anti-diuretic hormone [ADH] and as thirst changes, the amount of hormones that are in the body adapt as well. In hot weather, during exercise, or when more fluids are demanded, the levels of ADH go up to prevent fluids from being excreted. With central diabetes insipidus, there isn’t enough Vasopressin present to tell the kidneys what they are supposed to do. This can be caused by a wide variety of problems, but most typically results in damage to the pituitary gland or the hypothalamus in some way. Here are the common issues that may cause the development of central DI. 1. Genetic problems. Damage to the hypothalamus or the pituitary gland can be caused by genetic transfers. Although both parents can pass a defective gene to their child that causes this health issue, fathers are more likely to do so than mothers. 2. Head in Continue reading >>

Diabetes Insipidus

Diabetes Insipidus

On this page: What is diabetes insipidus? Diabetes insipidus is a rare disorder that occurs when a person's kidneys pass an abnormally large volume of urine that is insipid—dilute and odorless. In most people, the kidneys pass about 1 to 2 quarts of urine a day. In people with diabetes insipidus, the kidneys can pass 3 to 20 quarts of urine a day. As a result, a person with diabetes insipidus may feel the need to drink large amounts of liquids. Diabetes insipidus and diabetes mellitus—which includes both type 1 and type 2 diabetes—are unrelated, although both conditions cause frequent urination and constant thirst. Diabetes mellitus causes high blood glucose, or blood sugar, resulting from the body's inability to use blood glucose for energy. People with diabetes insipidus have normal blood glucose levels; however, their kidneys cannot balance fluid in the body. What are the kidneys and what do they do? The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the kidneys normally filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine. When the bladder empties, urine flows out of the body through a tube called the urethra, located at the bottom of the bladder. How is fluid regulated in the body? A person's body regulates fluid by balancing liquid intake and removing extra fluid. Thirst usually controls a person’s rate of liquid intake, while urination removes most fluid, although people also lose fluid through sweating, breathing, or diarrhea. The hormone vasopressin, also called antidiuretic hormone, con 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 >>

What Is Diabetes Insipidus?

What Is Diabetes Insipidus?

Most people have heard of the two main types of diabetes. But did you know the name has nothing to do with high blood sugar? It's a general term for any condition that causes your body to make a lot of urine. And that’s just what, diabetes insipidus does. This condition makes you extra thirsty. As a result, you pee -- a lot. Your body makes a substance called antidiuretic hormone (ADH). It’s produced in a part of your brain called the hypothalamus and stored in your pituitary gland. It tells your kidneys to hold onto water, which makes your urine more concentrated. When you’re thirsty or slightly dehydrated, ADH levels rise. Your kidneys reabsorb more water and put out concentrated urine. If you’ve had plenty to drink, ADH levels fall and what comes out is clear and dilute. When your body doesn’t make enough ADH, the condition is called central diabetes insipidus. If you make enough but your kidneys can't respond to it, you have nephrogenic diabetes insipidus. In either form, the result is the same. Your kidneys can't retain water, so even if you’re dehydrated, they'll put out a lot of pale, or diluted urine. When your kidneys can’t conserve water, you’ll: Get really thirsty Pee a lot -- this is known as polyuria Some people get dehydrated. If you lose too much water, you could have: Lethargy Muscle pains Irritability If you have this condition, you’ll probably wind up at the doctor for help with your thirst and constant need for a bathroom. To diagnose you, the doctor will do a series of blood and urine tests that may take several hours. You’ll go without water the whole time, so you’ll get thirstier. Your doctor will measure the sodium in your blood and pee. He may give you an ADH substitute to see if your kidneys respond by concentrating your ur Continue reading >>

Diabetes Insipidus

Diabetes Insipidus

What is diabetes insipidus? Diabetes insipidus (DI) is a rare condition that leads to frequent urination (passing a lot of clear urine) and excessive thirst. The condition may be caused by problems with your pituitary gland and/or your kidneys. DI is not related to diabetes mellitus (type 1 and type 2 diabetes), which is when your levels of blood sugar (glucose) are too high. How does your body regulate fluid? The amount of fluid in your body is a balance between how much liquid you drink and how much urine you make. Your kidneys and bladder are part of the system. Your kidneys remove extra fluid from your blood. If there' extra fluid in your system, your kidneys send it to your bladder. Your bladder stores and then excretes extra fluid as urine. If you take in less water, the kidneys make less urine and send water back into your blood. Antidiuretic hormone (ADH, also sometimes called vasopressin) is released if you get dehydrated and the sodium level in the blood rises, which helps your kidneys retain water. How is DI diagnosed? Your doctor has several ways to check for DI and to find the cause: Analysis of urine samples Blood tests to see how your pituitary gland is working A fluid deprivation test, which shows how well the kidneys are working. The test monitors the amount of urine made over the course of several hours without drinking fluids. You also might have an imaging test of your head (an MRI) to check for problems with your pituitary gland. Your doctor also may order genetic tests. What are the complications of DI? Taking too much desmopressin and/or drinking lots of fluids may cause low sodium levels in the blood, which can lead to headache, nausea, confusion, seizures or, in rare cases, death. Other complications are dehydration, low blood pressure, and high Continue reading >>

Diabetes Insipidus

Diabetes Insipidus

During the day, your kidneys filter all your blood many times. Normally, most of the water is reabsorbed, and only a small amount of concentrated urine is excreted. DI occurs when the kidneys cannot concentrate the urine normally, and a large amount of dilute urine is excreted. The amount of water excreted in the urine is controlled by 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 just below the base of the brain. DI caused by a lack of ADH is called central diabetes insipidus. When DI is caused by a failure of the kidneys to respond to ADH, the condition is called nephrogenic diabetes insipidus. Nephrogenic means related to the kidney. Central DI can be caused by damage to the hypothalamus or pituitary gland as a result of: Head injury Infection Loss of blood supply to the pituitary gland Surgery Nephrogenic DI involves a defect in the kidneys. As a result, the kidneys do not respond to ADH. Like central DI, nephrogenic DI is very rare. Nephrogenic DI may be caused by: Certain drugs, such as lithium Genetic problems Continue reading >>

Nephrogenic Diabetes Insipidus

Nephrogenic Diabetes Insipidus

Not to be confused with Neurogenic diabetes insipidus. Nephrogenic diabetes insipidus (also known as renal diabetes insipidus) is a form of diabetes insipidus primarily due to pathology of the kidney. This is in contrast to central/neurogenic diabetes insipidus, which is caused by insufficient levels of antidiuretic hormone (ADH, that is, arginine vasopressin or AVP). Nephrogenic diabetes insipidus is caused by an improper response of the kidney to ADH, leading to a decrease in the ability of the kidney to concentrate the urine by removing free water. Signs and symptoms[edit] The clinical manifestation is similar to neurogenic diabetes insipidus, presenting with excessive thirst and excretion of a large amount of dilute urine. Dehydration is common, and incontinence can occur secondary to chronic bladder distension.[1] On investigation, there will be an increased plasma osmolarity and decreased urine osmolarity. As pituitary function is normal, ADH levels are likely to be abnormal or raised. Polyuria will continue as long as the patient is able to drink. If the patient is unable to drink and is still unable to concentrate the urine, then hypernatremia will ensue with its neurologic symptoms.[citation needed] Causes[edit] Acquired[edit] Nephrogenic DI (NDI) is most common in its acquired forms, meaning that the defect was not present at birth. These acquired forms have numerous potential causes. The most obvious cause is a kidney or systemic disorder, including amyloidosis,[2] polycystic kidney disease,[3] electrolyte imbalance,[4][5] or some other kidney defect.[2] The major causes of acquired NDI that produce clinical symptoms (e.g. polyuria) in the adult are lithium toxicity and high blood calcium. Chronic lithium ingestion – appears to affect the tubules by enterin Continue reading >>

Everything You Should Know About Diabetes Insipidus

Everything You Should Know About Diabetes Insipidus

What is diabetes insipidus? Diabetes insipidus (DI) is a rare condition that occurs when your kidneys are not able to conserve water. DI is not related to diabetes mellitus, which is often referred to simply as diabetes. That means you can have DI without having diabetes. In fact, the condition can occur in anyone. DI results in extreme thirst and frequent urination of dilute and odorless urine. There are several types of DI, and they can often be successfully treated. Keep reading to learn more about this condition. The main symptoms of DI are excessive thirst, which can cause an uncontrollable craving for water, and excessive urine volume. A healthy adult will typically urinate less than 3 quarts of urine a day. People with DI may eliminate up to 16 quarts of urine a day. You may need to get up during the night to urinate frequently, or you may experience bed-wetting. Possible symptoms in young children and infants include: fussiness and irritability unusually wet diapers or bed-wetting, or excessive urine output excessive thirst dehydration high fever dry skin delayed growth Adults can experience some of the above symptoms, plus confusion, dizziness, or sluggishness. DI can also lead to severe dehydration, which can lead to seizures, brain damage, and even death if not treated. You should contact your doctor immediately if you or your child is experiencing these symptoms. To understand diabetes insipidus, it helps to understand how your body normally uses and regulates fluids. Fluids make up as much as 60 percent of your overall body mass. Maintaining the proper amount of fluid in your body is key to your overall health. Consuming water and food throughout the day helps provide fluid to your body. Urinating, breathing, and sweating help to eliminate fluid from your b Continue reading >>

Diabetes Insipidus

Diabetes Insipidus

Practice Essentials 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: 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. Signs and symptoms The predominant manifestations of DI are as follows: 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: In infants with DI, the most apparent signs may be the following: In children, the following manifestations typically predominate: If the condition that caused DI also damaged the anterior pituitary or hypothalamic centers that produce releasing factors, patients may present with the following: Physical findings vary with the severity and chronicity of DI; they may be entirely normal or may include the following: See Clinical Presentation for more detail. If the clinical presentation suggests DI, laboratory tests must be performed to confirm the diagnosis, as follows: Additional studies that may be indicated include the following: See Workup for more detail. Management Most patients with DI can drink enough fluid to replace their urine losses. When oral intake is inadequate and hypernatremia is present, provide fluid replacement as follows: Give dextrose and water or an intravenous fluid that is hypo-osmolar with respect to the patient’s serum; do not administer sterile water without dextrose IV Administer fluids at a rate no greater than 500-750 mL/hr; aim at reducing serum sodium by approximately 0.5 mmol/L (0.5 mEq/L) every hour Pharmacologic therapeutic options include the follo Continue reading >>

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