Diabetes insipidus Diagnosis

Diabetes insipidus Diagnosis - 2 Treat the underlying cause...

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Diabetes insipidus Diagnosis A full medical history is very important to identify the cause of DI. For example, history of head injury or recent surgery is very important as they are the most common causes. Initial laboratory tests: Serum electrolytes, especially sodium for hypernatremia Serum glucose (exclude Diabetes Mellitus for polyuria) Urine osmolarity (typically <300 mmol//kg) 24 urine collection (more than 3 L per day) Water deprivation test (urine osmolality < serum osmolality) = also excludes psychogenic polydipsia (urine osmolality will increase or normalise) AVP (desmopressin) stimulation test (differentiate central from peripheral cause . .. will increase urine osmolarity if central) Treatment Currently the treatment consists of: 1. Correct hypernatremia = preferred route is oral rehydration, but in some patients may have to correct with IV hypotonic fluids such as dextrose 5% and sodium chloride 0.45%.
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Unformatted text preview: 2. Treat the underlying cause Central: 1. Give parenteral or oral DDAVP (analogue of AVP) such as desmopressin 2. Regular monitoring of serum sodium and urine and serum osmolality to prevent dehydration Peripheral: 1. Maintains an adequate fluid intake 2. Low-sodium diet (<500 mg/day), thiazide diuretics can also be tried with the hope of reducing urinary output. Prognosis Usually cases of central DI are transient and resolve or over a matter of months. In patients with peripheral DI as a result of medications, the DI may be irreversible; although it would not be uncommon for it to resolve after discontinuation. Ultimately, it is a watch-and-wait process. Prevention Monitoring renal and urine output is important for patients taking medications known to induce DI....
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Diabetes insipidus Diagnosis - 2 Treat the underlying cause...

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