Diabetes insipidus
Framing
- Diabetes insipidus is impaired urinary concentrating ability causing polyuria and polydipsia - classified as cranial (inadequate ADH secretion from the posterior pituitary/hypothalamus) or nephrogenic (renal resistance to ADH action) - a distinction with different underlying mechanisms and different treatment, made through the water deprivation test and desmopressin response
- Distinguishing diabetes insipidus from primary polydipsia (excessive fluid intake driving the polyuria, rather than a concentrating defect) is a key diagnostic step preceding the cranial/nephrogenic distinction
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