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Diabetes insipidus (DI) is a rare endocrine disorder, characterized by excessive excretion of urine and raised thirst. During this condition, urinary system might pass even 10 times more urine than usual. The 2 most common types of diabetes insipidus include central diabetes insipidus (CDI) and nephrogenic diabetes insipidus (NDI). They are caused, respectively, by either hormone deficiency or kidneys dysfunction. The most popular symptoms include increased thirst, increased excretion of urine and frequent urination necessity. This type of endocrine disorder is fairly easy to control, and the complications are rare. The most dangerous consequence is a dehydration, which eventually may lead to death.
Diabetes insipidus characteristics
Each individual has two kidneys, a small organs located symmetrically below the rib cage. Their task is to filter blood from waste or any other unwanted substances, and further excrete them during urination. Diabetes insipidus affects the way the kidneys work. They are no longer able to concentrate the urine and filtrate properly, thus they pass away large volumes of dilute urine. What is more, this ailment results in excessive thirst as well. The combination of those two features is causing fluid imbalance, which is bad for organism.
Diabetes insipidus is a very rare disorder, resulting in approximately 3 incidents per 100,000 people annually. Sex or ethnic related prevalence is almost equal, however, some studies shown slightly bigger prevalence among males. The disease usually begins before the age of 20 years old. This endocrine disorder might be linked with diabetes mellitus, but in fact, the only similarity between them is the part of the name and increased urinating.
This condition can be divided into 4 different categories, and first two of them are the most common ones:
- Central diabetes insipidus (CDI), also referred to as Neurogenic DI.
- Nephrogenic diabetes insipidus (NDI)
- Dipsogenic diabetes insipidus
- Gestational diabetes insipidus
Diabetes insipidus causes and symptoms
There are 2 major causes that are triggering the diabetes insipidus. First of them is an insufficiency of arginine vasopressin (antidiuretic hormone), caused by various hypothalamus malfunctions. It is leading to central DI. The second common cause are kidney dysfunctions, further preventing from proper absorption and response to vasopressin. This leads to nephrogenic DI. Apart from this, the disease might also be caused by mental illness, pregnancy and abuse of alcohol or drugs.
Symptoms and signs are usually identical in most cases, however, their severity depends on patient’s age and particular organism’s abilities. Obviously, increased excretion of urine, in extreme cases 10 times more than usual, is the hallmark of this disease. Optionally, signs and symptoms related to dehydration may appear.
The most common symptoms include:
- Increased thirst
- Increased excretion of urine
- Frequent urination necessity (even during sleep)
Diagnosis and treatment
Although the disease bears almost unique combination of signs, the diagnosis is not always easy and clear, since this type of ailment might be caused by other conditions. A specialist must take into consideration every possibility, that is why the diagnosis can consist several tests, such as physical examination, urinalysis, head imaging (usually MRI), blood tests and fluid deprivation test.
Treatment is adjusted according to an origin of this condition. The most popular methods include replacing vasopressin with desmopressin (DDAVP), which is used for central or gestational DI treatment, and diuretics combined with aspirin or ibuprofen for nephrogenic DI treatment. What is interesting, truly effective method for dipsogenic DI has not been found yet.