Diabetes insipidus

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  • Mirjam Christ-Crain, Univ Basel, University of Basel, Dept Clin Res
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  • Daniel G. Bichet, Univ Montreal, University of Montreal, Fac Med, Dept Physiol
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  • Wiebke K. Fenske, Univ Hosp Leipzig, University of Leipzig, Endocrinol Nephrol Rheumatol, Med Dept 3
  • ,
  • Morris B. Goldman, Northwestern Univ, Northwestern University, Feinberg School of Medicine, Feinberg Sch Med, Dept Psychiat & Behav Sci
  • ,
  • Soren Rittig
  • Joseph G. Verbalis, Georgetown Univ, Georgetown University, Med Ctr, Div Endocrinol & Metab
  • ,
  • Alan S. Verkman, Univ Calif San Francisco, University of California System, University of California San Francisco, Dept Physiol

Diabetes insipidus (DI) is a disorder characterized by excretion of large amounts of hypotonic urine. Central DI results from a deficiency of the hormone arginine vasopressin (AVP) in the pituitary gland or the hypothalamus, whereas nephrogenic DI results from resistance to AVP in the kidneys. Central and nephrogenic DI are usually acquired, but genetic causes must be evaluated, especially if symptoms occur in early childhood. Central or nephrogenic DI must be differentiated from primary polydipsia, which involves excessive intake of large amounts of water despite normal AVP secretion and action. Primary polydipsia is most common in psychiatric patients and health enthusiasts but the polydipsia in a small subgroup of patients seems to be due to an abnormally low thirst threshold, a condition termed dipsogenic DI. Distinguishing between the different types of DI can be challenging and is done either by a water deprivation test or by hypertonic saline stimulation together with copeptin (or AVP) measurement. Furthermore, a detailed medical history, physical examination and imaging studies are needed to ensure an accurate DI diagnosis. Treatment of DI or primary polydipsia depends on the underlying aetiology and differs in central DI, nephrogenic DI and primary polydipsia.

Original languageEnglish
Article number54
JournalNature reviews. Disease primers
Volume5
Number of pages20
ISSN2056-676X
DOIs
Publication statusPublished - Aug 2019

    Research areas

  • VASOPRESSIN-NEUROPHYSIN-II, KIDNEY COLLECTING DUCT, DIFFERENTIAL-DIAGNOSIS, POLYDIPSIA-HYPONATREMIA, ANTIDIURETIC-HORMONE, POSTERIOR PITUITARY, ARGININE-VASOPRESSIN, PLASMA VASOPRESSIN, UNDERLYING THIRST, NATURAL-HISTORY

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