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Chapter: Medicine Study Notes : Endocrine and Electrolytes

Diabetes Insipidous - Electrolytes

Symptoms: polyuria, dilute urine despite dehydration, polydypsia

Diabetes Insipidous

 

·        Symptoms: polyuria, dilute urine despite dehydration, polydypsia


·        Central Diabetes Insipidous:

 

o   ¯Water resorption in kidney due to ¯ADH secretion from posterior pituitary ® low urine osmolality (eg 150 mosmol/kg) despite dehydration. > 5/l per day urine requires hypothalamic damage as well as posterior lobe

 

o   Causes of central DI: head injury, tumour, metastasis, sarcoidosis, vascular lesion, inherited, drugs (eg phenytoin), idiopathic (50%)

 

·        Nephrogenic DI:

o   Reduced response by kidney to ADH

 

o   Causes of nephrogenic DI: ¯K, ­Ca, drugs (lithium), pyelonephritis, congenital, loss of medullary hypertonicity (eg renal interstitial disease)

 

·        Tests:

o   U&E, Ca, plasma and urine osmolalities

 

o   Water deprivation test. Stop drinking then measure urine for 8 hours. If osmolality > 800 mosmol/kg then DI excluded. If diuresis continues, give nasal desmopresson and continue measuring

 

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Medicine Study Notes : Endocrine and Electrolytes : Diabetes Insipidous - Electrolytes |


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