Diabetes insipidus

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Diabetes insipidus is formed when the body cannot regulate the volume of liquids Normally, the kidney removes excess fluid from the blood This excess fluid is temporarily stored in the bladder as urine and then passed out through urination When the fluid regulation system is functioning properly, the kidney produces less urine than the body loses fluid in other ways, e.g. due to sweating or less fluid intake At this time, the liquid is stored

The volume and composition of body fluid is balanced by the rates of intake and excretion Fluid intake is caused by a feeling of thirst or a person's arbitrary decision to take a specific amount of fluid The rate and volume of fluid secretion in the kidneys is regulated by the antidiuretic (anti-urine secretion) hormone, which is also known as vasopressin.

Antidiuretic hormone is produced in the hypothalamus and is stored in the pituitary gland, a small gland located in the brain. The hormone is released into the blood when the body is dehydrated and needs to retain fluids Under the action of antidiuretic hormone, urine is concentrated as the renal tubules reabsorb water during filtration so that large amounts of water are not passed out as urine.

The type of diabetes insipidus is determined by the cause of this system disorder

• Central diabetes insipidus The cause of central diabetes insipidus is damage to the hypothalamus or pituitary gland, most often due to surgery, tumor, disease (eg meningitis), inflammatory or traumatic injury In children, the cause is often an inherited genetic disease Sometimes the reason cannot be determined Damage interferes with normal function, hormone production and storage
• Nephrogenic (renal) diabetes insipidus In this case, the defect is in the renal tubules – the structures of the kidney that cause water to be excreted or reabsorbed. Due to the defect, the kidney cannot respond to the effect of the hormone The defect may be due to genetic causes or chronic kidney disease Certain medications, such as lithium and demecocycline (a tetracycline antibiotic), also cause renal diabetes insipidus.
• Gestational diabetes insipidus Gestational diabetes develops during pregnancy when an enzyme produced by the placenta (a structure of blood vessels and tissues that exchanges nutrients and oxygen between the mother and the embryo) removes the antidiuretic hormone circulating in the mother's body.
• Primary polydipsia This condition, also called dipsogenic diabetes insipidus or psychogenic polydipsia, causes large volumes of urine to be produced. There is no problem in the production-storage of antidiuretic hormone, the cause of the disease is intake of an excessive amount of fluid Long-term intake of large amounts of water damages the kidneys and reduces the effect of antidiuretic hormone, which reduces the body's ability to concentrate urine. Primary polydipsia may be caused by pathological enhancement of thirst, as occurs during damage to the thirst regulatory centers (in the hypothalamus). Primary polydipsia can also be caused by mental illness

In some cases, the cause of diabetes insipidus cannot be determined

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The most common signs and symptoms of diabetes insipidus are:

• Severe thirst
• Excretion of large amounts of less concentrated urine
• Depending on the severity of the condition, the volume of urine produced varies from 2 liters per day (mild cases) to 20 liters per day (severe cases). In comparison, the average volume that a healthy adult excretes per day is only 1.5-2.5 liters
• Other symptoms may include urination at night (nocturia) and involuntary urination

Newborns and children with diabetes insipidus may have symptoms:

• Unexplained restlessness and crying
• Wetting an unusually large amount of diapers
• Fever, vomiting or diarrhea
• Dry skin, chills