Diabetes insipidus; nephrogenic

Alternative names:

acquired nephrogenic diabetes insipidus; gypsy's curse; nephrogenic diabetes insipidus

Treatment:

The goal of treatment is to regulate fluid levels in the body.

All cases should be treated with consistently high fluid intake. The volume of fluids consumed should approximately equal the volume of urine produced.

Reduction or discontinuation of medications that may cause nephrogenic DI may improve symptoms.

Hydrochlorothiazide may improve symptoms. This may be used alone or in combination with other medications including indomethacin and (occasionally) desmopressin. Although this medication is a diuretic (these medications are usually used to increase urine output), hydrochlorothiazide can actually reduce the urine output for people with nephrogenic dI. This medication works by causing sodium and water to be excreted in the early part of the renal tubules (the proximal tubules). This leaves less fluid available for the late portion of the kidney to excrete (distal tubule)--this is the portion affected by nephrogenic DI--and thus it limits the total volume of urine that can be excreted.

Expectations (prognosis):

Congenital nephrogenic dI is a chronic condition requiring lifelong treatment. Acquired nephrogenic dI may be short-term or long-term.

Complications:

• severe dehydration, shock (if inadequate fluid intake)
• hypernatremia (high blood sodium)
• dilation of the ureters and bladder

Calling your health care provider:

Call your health care provider if symptoms indicate diabetes insipidus may be present .