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Nephrogenic Diabetes Insipidus

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Nephrogenic Diabetes Insipidus, Nephrogenic DI

  • See Also
  1. Central Diabetes Insipidus
  2. Antidiuretic Hormone
  • Pathophysiology
  1. Deficient response by Kidney to Antidiuretic Hormone (ADH)
    1. Contrast with Central Diabetes Insipidus (deficient ADH)
  2. ADH fails increasing collecting duct water permeability
  3. 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