Diabetes insipidus

Mirjam Christ-Crain*, Daniel G. Bichet, Wiebke K. Fenske, Morris B Goldman, Soren Rittig, Joseph G. Verbalis, Alan S. Verkman

*Corresponding author for this work

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Abstract

Diabetes insipidus (DI) is a disorder characterized by excretion of large amounts of hypotonic urine. Central DI results from a deficiency of the hormone arginine vasopressin (AVP) in the pituitary gland or the hypothalamus, whereas nephrogenic DI results from resistance to AVP in the kidneys. Central and nephrogenic DI are usually acquired, but genetic causes must be evaluated, especially if symptoms occur in early childhood. Central or nephrogenic DI must be differentiated from primary polydipsia, which involves excessive intake of large amounts of water despite normal AVP secretion and action. Primary polydipsia is most common in psychiatric patients and health enthusiasts but the polydipsia in a small subgroup of patients seems to be due to an abnormally low thirst threshold, a condition termed dipsogenic DI. Distinguishing between the different types of DI can be challenging and is done either by a water deprivation test or by hypertonic saline stimulation together with copeptin (or AVP) measurement. Furthermore, a detailed medical history, physical examination and imaging studies are needed to ensure an accurate DI diagnosis. Treatment of DI or primary polydipsia depends on the underlying aetiology and differs in central DI, nephrogenic DI and primary polydipsia.

Original languageEnglish (US)
Article number54
JournalNature Reviews Disease Primers
Volume5
Issue number1
DOIs
StatePublished - Dec 1 2019

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ASJC Scopus subject areas

  • Medicine(all)

Cite this

Christ-Crain, M., Bichet, D. G., Fenske, W. K., Goldman, M. B., Rittig, S., Verbalis, J. G., & Verkman, A. S. (2019). Diabetes insipidus. Nature Reviews Disease Primers, 5(1), [54]. https://doi.org/10.1038/s41572-019-0103-2