Definition and causes
Diabetes insipidus is a rare condition in which the body produces large quantities of unconcentrated urine. Diabetes insipidus should not be confused with diabetes mellitus (diabetes).
Body fluid balance is regulated in the kidneys. This takes place under normal circumstances, that salt and water from the blood only low in the kidneys, forming precursors of urine. In the kidneys included salt and water back to the blood of the extent to which the body needs. If you drink sparingly on a hot day, the kidneys, for example. resume a higher proportion of salt and water, and extracted a sparse amount of force concentrated urine. Otherwise, if you drink more than your body needs
This highly sensitive regulatory mechanism is carried out, inter alia, of antidiuretic hormone (Vasopressin), which is excreted from the pituitary gland, a small gland located just below the brain. In diabetes insipidus is Vasopressin's regulation set out by force, either because of lack of separation of Vasopressin from the pituitary gland, called central diabetes insipidus, or due to reduced sensitivity of Vasopressin in the kidney, kidney condition called diabetes insipidus. The result will be in both cases the excretion of large amounts of urine, sometimes with life-threatening
Central diabetes insipidus can occur through direct damage to the pituitary, for example. at one of hypofysetumor damage to the skull or after surgery or radiotherapy to the area.
In kidney-related diabetes insipidus is renal sensitivity of Vasopressin reduced. This may be an inherited condition which occurs more frequently in men. In other cases, the condition caused by chronic renal failure, or be the result of toxic (poisonous) effects on the kidneys of certain medicinal products (eg. Certain antibiotics or lithium).
Symptoms of the disease (but not dehydration) can also be seen, if you drink excessive amounts of water. This is often associated with psychiatric illness.
Symptoms of diabetes insipidus
The symptoms are the same for both types of diabetes insipidus, and often develops over days to weeks. However, they may occur suddenly as a result of damage to the pituitary. The typical symptoms are:
- Elimination of large quantities of thin urine, up to 20 liters a day, but usually less than 10 liters.
- Thirst can not be alleviated.
- Disturbed sleep, because of frequent nocturnal pee itch.
- In addition, there are signs of massive dehydration, ie. Blur consciousness and disorientation.
Precautions and diagnosis
If you suspect diabetes insipidus, urine output can be measured over a 24 hour period. There may also created a "thirst test, which deprived total intake of fluid for several hours while measuring urine output. Under normal circumstances, urine output is reduced by fluid restriction, but if there is diabetes insipidus, urine output will remain high. Synthetic Vasopressin can be given a blood vessel to determine if the disease is central or kidney condition (see ovenf
Treatment and progress
Diabetes insipidus is usually treated with synthetic Vasopressin. If there is an underlying cause, such as. a hypofysetumor, handled this. Treatment with synthetic Vasopressin is in principle lifelong, but from time to time may be reading a movie to determine whether any disease. has gone away. If the disease is caused by a surgical procedure in the brain, is often transient. For good control and treatment can almost always be found symptoms.
The legacy, from kidney-related diabetes insipidus, where renal Vasopressin sensitivity is reduced, can be treated with synthetic Vasopressin be ineffective. In these cases, lifelong diet low in sodium and some diuretic agents for unclear reasons to be effective.
If the disease is caused temporary damage to the kidneys, for example. due to toxicity, the condition usually disappears when the toxic element is removed, and kidneys gradually recover.
For life-threatening dehydration treated with blood directly into the bloodstream.