Diabetes Insipidus: Symptoms, Causes, Treatment

Diabetes insipidus – colloquially known as water tap dysentery – is a hormone deficiency-related disorder in hydrogen metabolism that leads to extremely high urine excretion (polyuria; 5-25 l/day) due to a limited ability of the kidneys to concentrate. This is associated with an increased feeling of thirst (polydipsia; drinking quantity of 3.5 l/24 hours).

Two forms of diabetes insipidus can be distinguished:

  • Diabetes insipidus centralis (synonyms: central (neurogenic) diabetes insipidus; diabetes insipidus neurohormonalis; hypoyphric diabetes insipidus; ICD-10-GM E23.2: diabetes insipidus) – caused by a deficiency of the antidiuretic hormone (ADH) due to failure of ADH production (partial (partial) or total; permanent or transient (temporary)).
  • Diabetes insipidus renalis (synonym: nephrogenic diabetes insipidus; ICD-10-GM N25.1: Renal diabetes insipidus) – due to lack of or insufficient response of the kidneys (here: collecting tube and distal tubule) to ADH (ADH concentration is normal or even elevated)

These are rare diseases, although central diabetes insipidus is much more common than renal diabetes insipidus.

Course and prognosis: The course and prognosis depend on the form of diabetes insipidus. In most cases, the course is benign.The majority of patients with clinically manifest central diabetes mellitus receive drug therapy (with desmopressin), which serves to treat polyuria.In patients with nephrogenic diabetes insipidus, the underlying disease is treated as far as possible. This is often very protracted and often unsatisfactory. In addition to nutritional measures (restriction of protein and salt intake), medications (thiaziduretics; NSAID) are also used in this case.