Diabetes Insipidus

  • Nature: Excessive loss of hypotonic urine
  • Treatment: Fluid resuscitation greater than urine output

Cause

Central (Failed ADH secretion)

  • Idiopathic (30%)
  • CNS (60%)
    • Tumour 25%
    • Pituitary surgery, Sheehan’s, panhypopituitarism (20%)
    • Head trauma (15%)
    • CNS infection
    • CVA, Aneurysm
    • Sickle cell anaemia
    • Respiratory (10%) (usually granulomatous disease)
      • Wegener’s
      • Sarcoidosis
      • TB
      • Syphilis
      • Histiocytosis

Nephrogenic (No response to ADH) (Failed concentrating ability)

  • HYPOkalaemia, hypercalcaemia
  • Renal disorders (myeloma, amyloidosis, ATN, TIN)
  • Drugs as below

Drugs

  • Alcohol
  • Phenytoin
  • Amphotericin
  • Sulphonylureas
  • Colchicine
  • Gentamicin
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