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Nephrogenic Diabetes Insipidus

Understanding Fluid Regulation

Your body has a complex system for balancing the volume and composition of body fluids. Your kidneys remove extra body fluids from your bloodstream. This fluid waste is stored in the bladder as urine. If your fluid regulation system is working properly, your kidneys make less urine to conserve fluid when the body is losing water. Your kidneys also make less urine at night when the body's metabolic processes are slower.
In order to keep the volume and composition of body fluids balanced, the rate of fluid intake is governed by thirst, and the rate of excretion is governed by the production of antidiuretic hormone (ADH), also called vasopressin. This hormone is made in the hypothalamus, a small gland located in the base of the brain. ADH is stored in the nearby pituitary gland and released from it into the bloodstream when necessary. When ADH reaches the kidneys, it directs the kidneys to concentrate the urine by returning excess water to the bloodstream and therefore make less urine.

Causes of Nephrogenic Diabetes Insipidus

Nephrogenic diabetes insipidus results when the kidneys are unable to respond to ADH. With this condition, the kidneys' ability to respond to ADH can be impaired by drugs (like lithium, for example) and by chronic disorders, including:
  • Polycystic kidney disease
  • Sickle cell disease
  • Kidney failure
  • Partial blockage of the ureters
  • Inherited genetic disorders.
Sometimes, the cause of nephrogenic diabetes insipidus is never discovered.

What Are the Symptoms?

Nephrogenic diabetes insipidus causes frequent urination. The large volume of urine is diluted, mostly water. To make up for lost water, you may feel the need to drink large amounts. You are likely to urinate frequently, even at night, which can disrupt sleep or, on occasion, cause bedwetting. Because of the excretion of abnormally large volumes of dilute urine, you may quickly become dehydrated if you do not drink enough water.
Children with nephrogenic diabetes insipidus symptoms may be irritable or listless and may have fever, vomiting, or diarrhea.
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