Nephrogenic diabetes insipidus (DI) occurs when the renal tubules are unresponsive to circulating antidiuretic hormone (ADH).
Clinical findings:
(1) polyuria
(2) polydipsia
(3) dehydration
(4) altered mental status progressing to coma (encephalopathy)
(5) seizures
(6) lethargy and weakness
Laboratory findings:
(1) dilute urine (osmolality < 250 mOsm per kg water)
(2) serum hypernatremia
(3) serum hyperosmolality (> 292 mOsm per kg water)
(4) serum ADH normal to elevated
Parameters
Central DI
Nephrogenic DI
serum ADH
low
normal to elevated
response to subcutaneous vasopressin or desmopressin
clinical response
no response
A patient with nephrogenic diabetes responds to:
(1) discontinuation of cause if identifiable
(2) salt restriction
(3) thiazide diuretics
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Specialty: Endocrinology, Clinical Laboratory
ICD-10: ,
