by EBSCO Medical Review Board

Definition

Diabetes insipidus (DI) is when the kidneys pass a large amount of urine that is made up of mostly water.

There are 2 forms:

  • Central diabetes insipidus (central DI)
  • Nephrogenic diabetes insipidus (NDI)

Causes

Central DI happens when the body does not make enough of a hormone that controls urine. The cause is not always known. Rarely, it can be from a faulty gene. Some causes are:

  • Inflammation
  • Surgery
  • Head injury
  • Tumors
  • Infection

NDI happens when the body makes the hormone that controls urine but the kidneys do not respond to it. Causes are:

  • Some medicines, such as lithium
  • Metabolic causes, such as too much calcium or too little potassium
  • Something that blocks the urinary tract
  • Not eating enough protein
Pituitary Gland
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Risk Factors

DI is more common in people with other family members who have it. Central DI is more common in people with anterior pituitary hormone problems. NDI is more common in people who take lithium.

Symptoms

Symptoms may be:

  • Urinating more, often at night
  • Being very thirsty

Babies and children may be:

  • Fussy
  • Feed poorly
  • Not gaining weight
  • Urinating at night or wetting the bed

Diagnosis

The doctor will ask about your symptoms and health history. An exam may be done. Blood and urine tests will also be done.

These tests may be done to find the cause:

  • MRI scan
  • Lumbar puncture to test the fluid around the spine
  • Biopsy

Treatment

Central DI is treated with a man-made hormone that takes the place of the hormone that a person's body makes to control urine.

NDI may be treated with:

  • Drinking plenty of water
  • Treating the cause, such as too much calcium in the blood
  • Stopping or changing medicines, such as lithium

Prevention

There are no known ways to lower the chance of having DI.

RESOURCES

American Diabetes Association  http://www.diabetes.org 

Nephrogenic Diabetes Insipidus Foundation  http://www.ndif.org 

CANADIAN RESOURCES

Canadian Diabetes Association  http://www.diabetes.ca 

Health Canada  http://www.hc-sc.gc.ca 

References

Central diabetes insipidus. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/central-diabetes-insipidus  . Updated July 30, 2019. Accessed October 22, 2019.

Diabetes insipidus. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/kidney-disease/diabetes-insipidus. Updated October 2015. Accessed October 22, 2019.

Di Iorgi N, Napoli F, et al. Diabetes insipidus-diagnosis and management. Horm Res Paediatr. 2012;77(2):69-84.

Jain V. Ravindranath A. Diabetes insipidus in children. J Pediatr Endocrinol Metab. 2016 Jan;29(1):39-45. Available at: https://www.degruyter.com/view/j/jpem.2016.29.issue-1/jpem-2014-0518/jpem-2014-0518.xml. Accessed October 22, 2019.

Lu H. Diabetes insipidus. Adv Exp Med Biol. 2017;969:213-225.

Nephrogenic diabetes insipidus. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/nephrogenic-diabetes-insipidus/  . Updated October 2, 2018. Accessed October 22, 2019.

Oiso Y, Robertson GL, et al. Clinical review: Treatment of neurohypophyseal diabetes insipidus. J Clin Endocrinol Metab. 2013 Oct;98(10):3958-3967.

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