When caring for a patient with nephrogenic diabetes insipidus What should the nurse expect the treatment to include?

Diabetes insipidus is a rare condition that occurs when the kidneys are unable to conserve water during the process of filtering blood. This form of diabetes is different than diabetes mellitus or "sugar" diabetes. Both forms of diabetes are associated with excessive urination, but have different causes and treatments.

Diabetes insipidus is caused by a lack of antidiuretic hormone (ADH), also called vasopressin, which prevents dehydration, or the kidney's inability to respond to ADH. ADH enables the kidneys to retain water in the body. The hormone is produced in a region of the brain called the hypothalamus. It is stored and released from the pituitary gland, a small gland at the base of the brain.

When diabetes insipidus is caused by a lack of ADH, it is called central diabetes insipidus. This form of the disease can be caused by damage to the hypothalamus or pituitary gland.

When the condition is caused by a failure of the kidneys to respond to ADH, the condition is called nephrogenic diabetes insipidus, which may be inherited. This form of the disease involves a kidney defect that prevents the body from reabsorbing water back into the bloodstream. It is the rarest form of this uncommon disease.

Our Approach to Diabetes Insipidus

UCSF is an international leader in endocrinology care. Our team provides comprehensive consultations, evaluations and treatments for a wide range of hormone disorders, such as diabetes insipidus.

We treat this condition with a medication called desmopressin acetate, or DDAVP. The medication is similar to antidiuretic hormone, the hormone implicated in diabetes insipidus. We will adjust the dosage for each individual to find the right balance between controlling symptoms and avoiding complications. Our goal is to help our patients return to healthy, normal lives.

Summary

• Diabetes insipidus is characterised by extreme thirst and the passing of large amounts of urine.
• It is caused by the lack of sufficient vasopressin, a hormone produced by the brain that instructs the kidneys to retain water.
• Treatment options include vasopressin replacement.

This page has been produced in consultation with and approved by:

This page has been produced in consultation with and approved by:

Related information

• Hypertension, or high blood pressure, can increase your risk of heart attack, kidney failure and stroke.

• Diabetes and the build-up of glucose (sugar) in the blood can cause serious complications if left untreated.

• Good foot care and regular check-ups can help people with diabetes avoid foot problems.

• Gestational diabetes is diabetes that occurs during pregnancy and usually disappears when the pregnancy is over.

• Many parents worry when their child with diabetes starts or returns to school.

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Overview

Diabetes insipidus (DI) is a disease caused by a hormonal problem. It makes you feel very thirsty and urinate a lot. But it usually doesn't cause serious problems if you drink plenty of water. You can live a long and full life with DI.

There are two types of DI.

• Central diabetes insipidus happens when your body can't make enough of the hormone called antidiuretic hormone (ADH). ADH helps keep water in your body.
• Nephrogenic diabetes insipidus happens when your body makes enough ADH, but your kidneys don't respond to it. This causes your body to make too much urine.

DI isn't related to type 1 or type 2 diabetes. You don't have to worry about testing your blood sugar or insulin shots. Your treatment will include drinking plenty of fluids. It may also include medicines or changing how you eat.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

• Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor or nurse advice line if you think you are having a problem with your medicine.
• You may need to eat less salt and protein. It depends on the type of DI you have.
• You may need a diuretic medicine (a water pill). Your doctor may also prescribe other medicine.
• Drink lots of fluids. You need to drink more water than other people do. It's a good idea to carry water with you at all times.

When should you call for help?

Call your doctor or nurse advice line now or seek immediate medical care if:

• You have symptoms of dehydration, such as:
  • Dry eyes and a dry mouth.
  • Feeling much thirstier than usual.
• You are dizzy or light-headed, or you feel like you may faint.
• You are very confused and can't think clearly.

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you have any problems.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

Enter O483 in the search box to learn more about "Diabetes Insipidus: Care Instructions".

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