Diabetes insipidus - cranial
Description
- Deficient hypothalamic AVP (ADH) secretion -> failure to concentrate urine
- Polyuria (>3 L/day, or >50 mL/kg/day), nocturia, polydipsia, dilute urine
Renamed
| Old | Current |
|---|---|
| Cranial/central diabetes insipidus | Arginine vasopressin deficiency (AVP-D) |
| Nephrogenic diabetes insipidus | Arginine vasopressin resistance (AVP-R) |
- Renamed in 2022 to stop lethal confusion with diabetes mellitus - patients nil-by-mouth or on insulin protocols have died from withheld desmopressin
Degree
- Complete - AVP essentially absent, urine osmolality <300
- Partial - some residual AVP, intermediate concentrating ability
The three-way problem
- Every polyuria-polydipsia workup is AVP-D vs AVP-R vs primary polydipsia - and the last is the commonest and most often misdiagnosed
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