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Nephrogenic Diabetes Insipidus

 Syn. Nephrogenic DI

Signs & Symptoms

 Nocturia
Note: due to Polyuria
Ref: Uptodate [ Clinical manifestations and causes of nephrogenic diabetes insipidus] Epocrates [ https://www.epocrates.com/online/diseases/288/diabetes-insipidus#history-exam]
Polyuria
Note: due to Polydipsia, Urine output exceeding 3 L/day in adults or 2 L/m2 in children
Ref: Uptodate [ Clinical manifestations and causes of nephrogenic diabetes insipidus] Cecil [ 632] Epocrates [ https://www.epocrates.com/online/diseases/288/diabetes-insipidus#history-exam]
Concentrated Urine in the morning
Note: due to Lack of fluid ingestion overnight , due to increased vasopressin secretion during the late sleep period
Ref: Uptodate [ Clinical manifestations and causes of nephrogenic diabetes insipidus]
Increased vasopressin secretion during the late sleep period
Ref: Uptodate [ Clinical manifestations and causes of nephrogenic diabetes insipidus]

Physical Examination

 Not respond to the synthetic analogue
Ref: Cecil [ 632]
Dehydration
Note: due to Impaired Thirst, Unless thirst and/or the compensatory increase of fluid intake are also impaired
Ref: Harrison [ 2685]

Lab / Serology

 Low 24-h urine osmolarity
Note: The 24-h urine volume exceeds 40 mL/kg body weight , osmolarity is <300 mosmol/L
Ref: Harrison [ 2685]
High normal range serum sodium
Ref: Uptodate [ Clinical manifestations and causes of nephrogenic diabetes insipidus] Harrison [ 2685]
Increase serum osmolality level in response to water deprivation
Ref: Cecil [ 632]

Imagin Study

Complication

Risk Factors

Cause

 Lithium toxicity
Ref: Uptodate [ Clinical manifestations and causes of nephrogenic diabetes insipidus]

Other