Nephrogenic Diabetes Insipidus

Nephrogenic diabetes insipidus

DEFINITION

Nephrogenic diabetes insipidus is a disorder where the kidneys produce large amounts of dilute urine due to kidney fail to provide a response to antidiuretic hormone and unable to concentrate urine.

CAUSE

Under normal circumstances, the kidneys regulate the concentration of the urine according to the needs of the body. This arrangement is a response to antidiuretic hormone levels in the blood. Antidiuretic hormone (produced from the pituitary gland), a signal to the kidneys to retain water and concentrate urine. There are two types of diabetes insipidus. In the nephrogenic diabetes insipidus, the kidneys do not respond to antidiuretic hormone so that the kidneys are constantly issuing large amounts of dilute urine. On the other diabetes insipidus, the pituitary gland fails to produce antidiuretic hormone.

Diabetes insipidus may be a hereditary disease.

The gene that causes the disease is recessive and carried on the X chromosome, because it is only men of this disease.

Women who carry this gene can pass the disease to her son.

Other causes of nephrogenic diabetes insipidus are certain medications that can cause damage to the kidneys:

- Antibiotic aminoglycosides

- Demeklosiklin and other antibiotics

- Lithium (for treating manic-depressive illness).

SYMPTOMS

If it is a hereditary disease, the symptoms usually begin to appear soon after birth. Symptoms include excessive thirst (polidipsi) and spending large amounts of dilute urine (polyuria). Babies can not express his thirst, so that they can become dehydrated. Babies may experience high fever accompanied by vomiting and convulsions. If not promptly diagnosed and treated, can damage the brain, so that the babies have mental retardation. Dehydration is often repeated will also hinder physical development.

Diagnosis

Diagnosis based on symptoms. Laboratory tests showed high levels of sodium in the blood and urine is very dilute. Other kidney function appears normal. To confirm the diagnosis, assessment of renal response to antidiuretic hormone through the water deprivation test.

TREATMENT

To prevent dehydration, the patient should always drink adequate amounts of fluid when they feel thirsty. People with babies and children have often been watered. If insufficient fluid intake, dehydration is rare. Certain medications can help, such as thiazide diuretics (eg hidrochlorothiazid / HCT) and medication non-steroidal anti-inflammatory (such as indometacin or tolmetin).