Diabetes insipidus is a disease accompanied by the release of large amounts of urine and intense thirst, as a result of a violation of the production of antidiuretic hormone (vasopressin) or a decrease in the sensitivity of the kidneys to it.
Vasopressin (antidiuretic hormone) is produced in the hypothalamus and stored in the pituitary gland. Vasopressin reduces the amount of daily urine. With its deficiency, the kidneys begin to secrete an excess amount of non-concentrated (having a low specific gravity) urine. In some cases, the volume of daily urine reaches 40 liters or more.
Unlike diabetes, the urine of patients does not contain glucose and has a low density. To make up for the loss of fluid, the thirst center is activated in the body. If a person does not have the opportunity to constantly replenish the loss of fluid, dehydration develops.
Causes of diabetes insipidus:
- Traumatic brain injury;
- Surgery on the brain;
- hereditary factors;
- Tumors, vascular formations of the brain (aneurysms);
- Infectious diseases (meningitis, encephalitis, syphilis).
Symptoms of diabetes insipidus:
- An increase in the amount of daily urine, first up to 5-6 liters, then more;
- Increased urination, even at night;
- Intense thirst to compensate for fluid loss. If the patient does not replenish the fluid deficiency, signs of dehydration develop (dry mouth, dry and sagging skin, weakness, palpitations, pressure drop, coma). With a sufficient amount of fluid to drink, the condition does not worsen for a long time.
Further developed:
- Sleep disturbance, fatigue;
- Violation of the stool, pain in the stomach, nausea – as a result of prolapse and distension of the stomach;
- Decreased blood pressure, increased heart rate.
In children, the disease is more severe and complications develop earlier.
Diagnostics:
An endocrinologist deals with the diagnosis and treatment of the disease.
The diagnosis is made after the exclusion of diabetes mellitus (normal blood glucose, no sugar in the urine) and kidney pathology.
Diagnostically significant is an increase in the daily amount of urine more than 3 liters and a decrease in urine density (specific gravity) less than 1005.
A test with dry eating is carried out.
In addition, additional research may be required to exclude space-occupying formations in the brain.
Treatment:
The disease proceeds for a long time, postoperative diabetes insipidus usually resolves on its own with time. The prognosis for life is favorable.
If the cause of diabetes insipidus is a decrease in the production of vasopressin, lifelong therapy with its synthetic analogues is carried out – replacement therapy.
With a decrease in the sensitivity of the kidneys to vasopressin, therapy with thiazide diuretics, lithium preparations, and non-steroidal anti-inflammatory drugs is carried out.
All patients are recommended a diet rich in carbohydrates, frequent, fractional meals.
