Endo

Nephrogenic Diabetes Insipidus

search

Nephrogenic Diabetes Insipidus, Nephrogenic DI

  • Definition
  1. Deficient response by Kidney to Antidiuretic Hormone
  • Pathophysiology
  1. ADH fails increasing collecting duct water permeability
  2. Failed countercurrent mechanism
    1. Inadequate generation of hypertonic interstitium
  • Causes
  1. Congenital
  2. Chronic disease of renal Medulla
    1. Medullary cystic disease
    2. Pyelonephritis
  3. Protein deficient diet
  4. Salt deficient diet
  5. Hypercalcemia
  6. Hypokalemia
  7. Amyloidosis
  8. Multiple Myeloma
  9. Medications
    1. Demeclocycline
    2. Lithium
    3. Glyburide
  • Diagnosis
  1. Fluid Deprivation Test
    1. No response to water deprivation
    2. No response to exogenous ADH administration
  2. Hare-Hickey Test
    1. Increased ADH to Serum Osmolality ratio