Condition Info - BotMed Application

ConditionName

Diabetes insipidus (DI)

ConditionDescription

Symptoms

Confusion, disorientation, lethargy, seizures;
Polydipsia; Polyuria; Dehydration.
Not concentrated urine, polyuria

PhysicalFindings

ClinicalTests

Most accurate test: CDI: Give vasopressin (drug, ADH) 
NDI: no effect

↑serum Na 
↓urine osmolality
↓serum osmolality

Conformation of diagnosis: water deprivation test: if urine not concentrated even after water restriction -> DI

Give ADH -> corrected -> central DI, not -> nephrogenic DI

Hyper Ca or Hypo K inhibit ADH;
Hyper Na -> neurology:

RiskFactors

Brain damage history (hypothalamus):
Stroke, tumor, trauma, hypoxia, infiltration (sarcoidosis, hemochromatosis)
Infection; 
Any space occupied lesion;
Radiotherapy.

IsRedFlag

IsNPLEX

Consequence

Disorders of ADH-directed water reabsorption leading to dehydration and hypernatremia;
Coma;

ProgressionFromCondition

Kidney doesn’t respond to ADH:
History of chronic pyelonephritis, amyloidosis, myeloma, sickle cell dz, lithium;
Hypercalcemia;

Most common: drug induced;

TreatmentOptions

Drink enough water with electroliers;

PharmOptions

CDI: long term vasopressin;
NDI: correct the cause;
Hydrochlorothiazide, NSAID;

Give Desmopressin.

WebLink

https://www.merckmanuals.com/en-ca/professional/endocrine-and-metabolic-disorders/pituitary-disorders/central-diabetes-insipidus | https://www.merckmanuals.com/en-ca/professional/genitourinary-disorders/renal-transport-abnormalities/nephrogenic-diabetes-insipidus