Central and nephrogenic diabetes insipidus: updates on diagnosis and management
Diabetes insipidus (DI) is a rare endocrine disease involving antidiuretic hormone (ADH), encompassing both central and nephrogenic causes. Inability to respond to or produce ADH leads to inability of the kidneys to reabsorb water, resulting in hypotonic polyuria and, if lack of hydration, hypernatr...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2024.1479764/full |
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| author | Kathryn Flynn Jennifer Hatfield Kevin Brown Nicole Vietor Thanh Hoang |
| author_facet | Kathryn Flynn Jennifer Hatfield Kevin Brown Nicole Vietor Thanh Hoang |
| author_sort | Kathryn Flynn |
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| description | Diabetes insipidus (DI) is a rare endocrine disease involving antidiuretic hormone (ADH), encompassing both central and nephrogenic causes. Inability to respond to or produce ADH leads to inability of the kidneys to reabsorb water, resulting in hypotonic polyuria and, if lack of hydration, hypernatremia. DI cannot be cured and is an unfamiliar disease process to many clinicians. This diagnosis must be distinguished from primary polydipsia and other causes of hypotonic polyuria. The main branchpoints in pathophysiology depend on the level of ADH pathology: the brain or the kidneys. Prompt diagnosis and treatment are critical as DI can cause substantial morbidity and mortality. The gold standard for diagnosis is a water deprivation test followed by desmopressin administration. There is promising research regarding a new surrogate marker of ADH called copeptin, which may simplify and improve the accuracy in diagnosing DI in the future. Patients with DI require adequate access to water, and there are nuances on treatment approaches depending on whether a patient is diagnosed with central or nephrogenic DI. This article describes a stepwise approach to recognition, diagnosis, and treatment of DI. |
| format | Article |
| id | doaj-art-03c91319b0f549dda1d4ed0fd5238244 |
| institution | Kabale University |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj-art-03c91319b0f549dda1d4ed0fd52382442025-01-08T05:10:27ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-01-011510.3389/fendo.2024.14797641479764Central and nephrogenic diabetes insipidus: updates on diagnosis and managementKathryn Flynn0Jennifer Hatfield1Kevin Brown2Nicole Vietor3Thanh Hoang4Department of Internal Medicine, Walter Reed National Military Medical Center, Bethesda, MD, United StatesDepartment of Endocrinology, Walter Reed National Military Medical Center, Bethesda, MD, United StatesDepartment of Endocrinology, Walter Reed National Military Medical Center, Bethesda, MD, United StatesDepartment of Endocrinology, Walter Reed National Military Medical Center, Bethesda, MD, United StatesDepartment of Endocrinology, Walter Reed National Military Medical Center, Bethesda, MD, United StatesDiabetes insipidus (DI) is a rare endocrine disease involving antidiuretic hormone (ADH), encompassing both central and nephrogenic causes. Inability to respond to or produce ADH leads to inability of the kidneys to reabsorb water, resulting in hypotonic polyuria and, if lack of hydration, hypernatremia. DI cannot be cured and is an unfamiliar disease process to many clinicians. This diagnosis must be distinguished from primary polydipsia and other causes of hypotonic polyuria. The main branchpoints in pathophysiology depend on the level of ADH pathology: the brain or the kidneys. Prompt diagnosis and treatment are critical as DI can cause substantial morbidity and mortality. The gold standard for diagnosis is a water deprivation test followed by desmopressin administration. There is promising research regarding a new surrogate marker of ADH called copeptin, which may simplify and improve the accuracy in diagnosing DI in the future. Patients with DI require adequate access to water, and there are nuances on treatment approaches depending on whether a patient is diagnosed with central or nephrogenic DI. This article describes a stepwise approach to recognition, diagnosis, and treatment of DI.https://www.frontiersin.org/articles/10.3389/fendo.2024.1479764/fulldiabetes insipiduscentral diabetes insipidusnephrogenic diabetes insipiduspolyuriapolydipsiacopeptin |
| spellingShingle | Kathryn Flynn Jennifer Hatfield Kevin Brown Nicole Vietor Thanh Hoang Central and nephrogenic diabetes insipidus: updates on diagnosis and management Frontiers in Endocrinology diabetes insipidus central diabetes insipidus nephrogenic diabetes insipidus polyuria polydipsia copeptin |
| title | Central and nephrogenic diabetes insipidus: updates on diagnosis and management |
| title_full | Central and nephrogenic diabetes insipidus: updates on diagnosis and management |
| title_fullStr | Central and nephrogenic diabetes insipidus: updates on diagnosis and management |
| title_full_unstemmed | Central and nephrogenic diabetes insipidus: updates on diagnosis and management |
| title_short | Central and nephrogenic diabetes insipidus: updates on diagnosis and management |
| title_sort | central and nephrogenic diabetes insipidus updates on diagnosis and management |
| topic | diabetes insipidus central diabetes insipidus nephrogenic diabetes insipidus polyuria polydipsia copeptin |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2024.1479764/full |
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