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Diabetes insipidus - central
Central diabetes insipidus
Central diabetes insipidus is a rare condition that involves extreme thirst and excessive urination.
Causes
Diabetes insipidus (DI) is an uncommon condition in which the kidneys are unable to prevent the excretion of water. Diabetes insipidus is a different disease than diabetes , though both share common symptoms excessive urination and thirst.
Diabetes insipidus (DI)
Diabetes insipidus is an uncommon condition in which the kidneys are unable to prevent the excretion of water.
Diabetes
Diabetes is a chronic disease in which the body cannot regulate the amount of sugar in the blood.
Excessive urination
Excessive amount of urination means that your body makes larger than normal amounts of urine each day.
Central diabetes insipidus is a form of DI that occurs when the body has a lower than normal amount of antidiuretic hormone (ADH). ADH is also called vasopressin . ADH is produced in a part of the brain called the hypothalamus . It is then stored and released from the pituitary gland. This is a small gland at the base of the brain.
Vasopressin
Antidiuretic blood test measures the level of antidiuretic hormone (ADH) in blood.
Hypothalamus
The hypothalamus is an area of the brain that produces hormones that control:Body temperatureHungerMoodRelease of hormones from many glands, especial...
ADH controls the amount of water excreted in urine. Without ADH, the kidneys do not work properly to keep enough water in the body. The result is a rapid loss of water from the body in the form of dilute urine. This results in the need to drink large amounts of water due to extreme thirst and to make up for excessive water loss in the urine (as much as 4 gallons or 15 liters a day).
The reduced level of ADH may be caused by damage to the hypothalamus or pituitary gland. This damage may be due to surgery, infection, inflammation, tumor , or injury to the brain .
Tumor
A tumor is an abnormal growth of body tissue. Tumors can be cancerous (malignant) or noncancerous (benign).
Injury to the brain
A head injury is any trauma to the scalp, skull, or brain. The injury may be only a minor bump on the skull or a serious brain injury. Head injury c...
Sometimes the cause is unknown. In rare cases, central diabetes insipidus is caused by a genetic problem.
Symptoms
Symptoms of central diabetes insipidus include:
- Increased urine production
- Excessive thirst
- Confusion and changes in alertness due to dehydration and higher than normal sodium level in the body, if the person is unable to drink
Exams and Tests
The health care provider will ask about your medical history and symptoms.
Tests that may be ordered include:
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Blood sodium
and
osmolarity
Blood sodium
The sodium blood test measures the amount of sodium in the blood. Sodium can also be measured using a urine test.
ImageRead Article Now Book Mark ArticleOsmolarity
The osmolality urine test measures the concentration of particles in urine. Osmolality can also be measured using a blood test.
ImageRead Article Now Book Mark Article - Desmopressin (DDAVP) challenge
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MRI of the head
MRI of the head
A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
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Urinalysis
Urinalysis
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...
ImageRead Article Now Book Mark Article -
Urine concentration
Urine concentration
A urine concentration test measures the ability of the kidneys to conserve or excrete water.
ImageRead Article Now Book Mark Article - Urine output
Treatment
The cause of the underlying condition will be treated.
Vasopressin (desmopressin, DDAVP) is given either as a nasal spray, tablets, or injections. This controls urine output and fluid balance and prevents dehydration .
Dehydration
Dehydration occurs when your body does not have as much water and fluids as it should. Dehydration can be mild, moderate, or severe, based on how muc...
In mild cases, drinking more water may be all that is needed. If the body's thirst control is not working (for example, if the hypothalamus is damaged), a prescription for a certain amount of water intake may also be needed to ensure proper hydration.
Outlook (Prognosis)
Outcome depends on the cause. If treated, central diabetes insipidus usually does not cause severe problems or result in early death.
Possible Complications
Not drinking enough fluids can lead to dehydration and electrolyte imbalance.
Electrolyte
Electrolytes are minerals in your blood and other body fluids that carry an electric charge. Electrolytes affect how your body functions in many ways...
When taking vasopressin and your body's thirst control is not normal, drinking more fluids than your body needs can cause dangerous electrolyte imbalance.
When to Contact a Medical Professional
Call your provider if you develop symptoms of central diabetes insipidus.
If you have central diabetes insipidus, contact your provider if frequent urination or extreme thirst returns.
Prevention
Many of the cases may not be preventable. Prompt treatment of infections, tumors, and injuries may reduce risk.
References
Bichet DG. Polyuria and diabetes insipidus. In: Alpern RJ, Caplan M, Moe OW, eds. Seldin and Giebisch's The Kidney . 5th ed. Philadelphia, PA: Elsevier; 2013:chap 46.
Carr AC. Diabetes insipidus and other polyuric syndromes. In: Berstein AD, Soni N, eds. Oh's Intensive Care Manual . 7th ed. Philadelphia, PA: Elsevier; 2014:chap 59.
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Endocrine glands - illustration
Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the pace of chemical activity in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).
Endocrine glands
illustration
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Endocrine glands - illustration
Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the pace of chemical activity in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).
Endocrine glands
illustration
Review Date: 10/13/2015
Reviewed By: Walead Latif DO, nephrologist, Medical Director of Fresenius Vascular Care, and Clinical Assistant Professor of Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
