Diabetes Insipidus is a kind of desease in which there is unbearable thirsty and unconditioned passage of highly diluted urine though there is a limited fluid intake or a condiion of dehydraion. There is anoher kind wih a similar name Diabetes Mellitus which is entirely from different etiology.The word Diabetes ment in Greek as siphon.In this desease only water is siphoned from the body without any salt or any substance to be excreted from the body on the contrary to Diabetes mellitus in which glucose break the kidney threshold and drained out in urine.
There are many type of DI but the most common type which we are going to deal here is purely from neurological origin known as Central DI (CDI) which is due to a deficiency of Arginine Vasopressin (AVP) also known as ANTI DIURETIC HORMONE(ADH)
The other type is nephrogenic in which due to some unknown cause kidney may not respond to ADH.
Also there is gestational GI which occurs at the time of pregnancy o some ladies
Alcohol and some other drug abuse may cause ADH
ADH should not be confused wih nocturea a condition which compels o pass urine a night
In DI more water is excreted due to either a deficiency of ADH or the lack ok kidney response to the ADH where as in DM more water is excreed due to a process known as iso-osmolar pressure due to high glucose content in the blood
Fortunately the incidence of DI is 3 in 100000(A)
Signs and Symptoms
Extreme thirst and excessive and frequent urine passage may look similar to DM but differing by having no sugar and conents and only empty water.he paient can survive for decades if he drink excessive water daily to takle the ready to threaten dehydration.Otherwice an adult can experience all the symptoms of dehydration including tiredeness,fainting,a child will experience loss of appetite fever,vomiting,diarrhoea moodchange etc.etc.
Diagnosis
To distinguish DI from other causes need to be eliminated by testing Glucose,Bicarbonate,and Calcium levels.
Measurement of sodium level needs to be performed as dehydration leads to hypernatremia in the blood.
Urine specific gravity,Osmolality,and elecrolyte levels are extremely low as the absence or irresponciveness to the hormone ADH leads to the irregular absorptions and secretions of elecrolyte in the kidney mainly sodium and potassium exchange at Distal tubule of the nephron
To distinguish between the etiologies whether it is due to hormona deficiency or lack of kidney response to the hormone Desmopressin Inj is used.In this test as the desmopressin represens ADH and after its administration if the patient feels normal then the conclusion is the cause is due to the deficiency of hormone and no because kidney..
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| ANTI DIURETIC HORMONE STRUCTURE |
