This document discusses diabetes insipidus, which is characterized by excessive urine production and thirst. It can be caused by a deficiency or insensitivity to antidiuretic hormone. There are different types, including cranial and nephrogenic diabetes insipidus. Symptoms include polyuria, nocturia, and dehydration if untreated. Diagnosis involves urine and blood tests and imaging. Treatment depends on the underlying cause but may include desmopressin for cranial diabetes insipidus or thiazide diuretics for nephrogenic diabetes insipidus.

2. • MECHANISM OF ADH
• DEFINITION
• TYPES F DI
• CRANIAL DI
• NEPHROGENIC DI
• CLINICAL FEATURES
• INVESTIGATION
• MANAGEMENT

4. “Diabetes insipidius is an
uncommon disorder
which is characterised
by the persistent
excretion of excessive
quantities of dilute
urine and by thirst”
Either due to deficiency
of ADH or insensitivity
to its action

5. NEPHROGE
CRANIAL DIPSOGENIC GESTATIONAL
-NIC
DIABETES DIABETES DIABETES
DIABETES
INSIPIDIUS INSIPIDIUS INSIPIDIUS
INSIPIDIUS

7. FAMILIAL:
(vasopressin receptor
gene
aqua porin-2 gene
defect).
IdIopAthIc.
RenAL tubuLAR
AcIdosIs.
hypokALeMIA
hypeRcALceMIA
dRugs (lithium ,
demeclocycline)

8. Polyuria Nocturia
Dehydration
Compensatory
polydipisia

9. Samples of blood and urine
 Dynamic test
Assesment of Anterior pituitary function and
supresellar anatomy
MRI
Plasma electrolytes
Calcium
Investigation of renal tract

10.  Treatment of reversible underlying
cause (eg. A hypothalamic tumour)
CRANIAL DI
• Des-amino-des-aspartate-arginine vasopressin DDAVP
Intranasally (10 – 20 µg once or twice daily
Orally 200µg thrice daily
and IM 2-4µg once daily

11. NEPHROGENIC DI
• THIAZIDE DIURETICS hydrochlorothiazides
• CARBAMAZEPINE 200 – 400 mg daily
• CHLORPROPAMIDE 200-400 mg daily
• NSAIDS (indomethacin 15 mg 8 hourly
Lithium-induced nephrogenic DI may be
effectively managed with the administration of amiloride, a
potassium-sparing diuretic often used in conjunction with
thiazide or loop diuretics.