genitourinary disorders
Nephrogenic Diabetes Insipidus
Introduction
Nephrogenic diabetes insipidus (NDI) is an inability to concentrate urine due to impaired renal tubule response tovasopressin(ADH), which leads to excretion of large amounts of dilute urine. It can be inherited or occur secondary to conditions that impair renal concentrating ability. Symptoms and signs include polyuria and those related to dehydration and hypernatremia. Diagnosis is based on measurement of urine osmolality changes after water deprivation and administration of exogenousvasopressin. Treatment consists of adequate free water intake, thiazide diuretics, nonsteroidal anti-inflammatory drugs, and a low-salt, low-protein diet. (See also ArginineVasopressin Deficiency (Central Diabetes Insipidus) .) NDI is characterized by inability to concentrate urine in response tovasopressin.Argininevasopressindeficiency is characterized by lack ofvasopressin. Either type of diabetes insipidus may be complete or partial. 