Diabetes insipidus is the deficiency or resistance to the hormone vasopressin (antidiuretic hormone), which results in polyuria and polydipsia.
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Epidemiology
Diabetes insipidus occurs in 3 per 100,000 people 2.
Pathology
Diabetes insipidus may be described as 1-3:
- central/neurogenic/hypothalamic: vasopressin deficient (more common)
- peripheral/nephrogenic: vasopressin resistant
Etiology
-
central diabetes insipidus: reduced secretion of vasopressin
- trauma
- neurosurgery
- malignancy, e.g. craniopharyngioma, germinoma, metastases
- autoimmune disease, e.g. lymphocytic hypophysitis
- inflammatory disease, e.g. sarcoidosis, Langerhans cell histiocytosis, IgG4-related
- infection, e.g. tuberculosis
- pregnancy
- familial (rare)
- idiopathic
-
peripheral diabetes insipidus: increased end-organ resistance to vasopressin
- congenital renal insensitivity to vasopressin (rare)
- long-term lithium use (15% of patients)
- metabolic, e.g. hypokalemia, hypercalcemia
- chronic kidney disease
- pregnancy
Treatment and prognosis
Desmopressin can be used to treat central diabetes insipidus 4.