• MECHANISM OF ADH• DEFINITION• TYPES F DI• CRANIAL DI• NEPHROGENIC DI• CLINICAL FEATURES• INVESTIGATION• MANAGEMENT
“Diabetes insipidius is an uncommon disorder which is characterised by the persistent excretion of excessive quantities of dilute urine and by thirst”Either due to deficiency of ADH or insensitivity to its action
Samples of blood and urine Dynamic testAssesment of Anterior pituitary function and supresellar anatomyMRIPlasma electrolytesCalciumInvestigation of renal tract
Treatment of reversible underlying cause (eg. A hypothalamic tumour)CRANIAL DI• Des-amino-des-aspartate-arginine vasopressin DDAVPIntranasally (10 – 20 µg once or twice dailyOrally 200µg thrice dailyand IM 2-4µg once daily
NEPHROGENIC DI• THIAZIDE DIURETICS hydrochlorothiazides• CARBAMAZEPINE 200 – 400 mg daily• CHLORPROPAMIDE 200-400 mg daily• NSAIDS (indomethacin 15 mg 8 hourlyLithium-induced nephrogenic DI may be effectively managed with the administration of amiloride, a potassium-sparing diuretic often used in conjunction with thiazide or loop diuretics.