Diabetes insipidus - Revision history

Ostermayer: /* Evaluation */

2022-02-28T00:17:09Z

Evaluation

← Older revision		Revision as of 00:17, 28 February 2022
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	==Evaluation==		==Evaluation==
			*Urine specific gravity < 1.010
	*Measure serum and urine sodium while patient is water-deprived		*Measure serum and urine sodium while patient is water-deprived
	**Lack of response to water deprivation is diagnostic		**Lack of response to water deprivation is diagnostic

SuperD: /* Management */

2020-01-26T13:38:03Z

Management

← Older revision		Revision as of 13:38, 26 January 2020
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	*Volume repletion with [[normal saline]] or lactated ringers solution		*Volume repletion with [[normal saline]] or lactated ringers solution
	*Patients will be water-deprived		*Patients will be water-deprived
	**Calculate water deficit: [Water deficit (in Liters) = ((Measured sodium/Normal sodium)-1)]		**Calculate water deficit: Water deficit (in Liters) = [(Body weight(kg)x0.6)x((Measured sodium/Normal sodium)-1)]
	*Serum sodium should not decrease by more than 10-15 mEq/L per day in chronic cases of hypernatremia		*Serum sodium should not decrease by more than 10-15 mEq/L per day in chronic cases of hypernatremia
	**Over-aggressive reduction of serum sodium may result in cerebral edema secondary to presence of idiogenic osmoles the build up in brain cells when exposed to chronic hypernatremia		**Over-aggressive reduction of serum sodium may result in cerebral edema secondary to presence of idiogenic osmoles the build up in brain cells when exposed to chronic hypernatremia

ClaireLewis at 15:35, 28 September 2019

2019-09-28T15:35:46Z

← Older revision		Revision as of 15:35, 28 September 2019
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	**Idiopathic		**Idiopathic
	*Nephrogenic DI		*Nephrogenic DI
	**Renal disease		**[[renal failure\|Renal disease]]
	**Drug Induced (e.g [[Lithium]])		**Drug Induced (e.g [[Lithium]])
	**[[Hypokalemia]]		**[[Hypokalemia]]
	**[[Hypercalcemia]]		**[[Hypercalcemia]]
	**[[Polycystic kidney disease]]		**[[Polycystic kidney disease]]
	**[[~~Sjogren's~~]]		**[[Sjögren syndrome]]
	**[[Amyloidosis]]		**[[Amyloidosis]]

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	*[[Hypernatremia]]		*[[Hypernatremia]]
	*Decreased urine osmolality		*Decreased urine osmolality
	*Dehydration		*[[Dehydration]]
	*Irritability		*Irritability
	*~~Tremors~~		*[[Tremor]]s
	*[[Ataxia]]		*[[Ataxia]]
	*Hyperreflexia		*Hyperreflexia
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	**Serum Osm >295 mOsm/L		**Serum Osm >295 mOsm/L
	*Record response to 5 units subcutaneous [[vasopressin]]		*Record response to 5 units subcutaneous [[vasopressin]]
	**Response to vasopressin is diagnostic of central DI (response is indicated by urine osm >800 mOsm/L)		**Response to [[vasopressin]] is diagnostic of central DI (response is indicated by urine osm >800 mOsm/L)
	**No response is diagnostic of nephrogenic DI		**No response is diagnostic of nephrogenic DI
	*In adults, onset of central DI usually abrupt whereas onset gradual in nephrogenic DI		*In adults, onset of central DI usually abrupt whereas onset gradual in nephrogenic DI
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	*Patients will be water-deprived		*Patients will be water-deprived
	**Calculate water deficit: [Water deficit (in Liters) = ((Measured sodium/Normal sodium)-1)]		**Calculate water deficit: [Water deficit (in Liters) = ((Measured sodium/Normal sodium)-1)]

	*Serum sodium should not decrease by more than 10-15 mEq/L per day in chronic cases of hypernatremia		*Serum sodium should not decrease by more than 10-15 mEq/L per day in chronic cases of hypernatremia
	**Over-aggressive reduction of serum sodium may result in cerebral edema secondary to presence of idiogenic osmoles the build up in brain cells when exposed to chronic hypernatremia		**Over-aggressive reduction of serum sodium may result in cerebral edema secondary to presence of idiogenic osmoles the build up in brain cells when exposed to chronic hypernatremia

Sabedi: /* Evaluation */

2018-10-22T02:52:35Z

Evaluation

← Older revision		Revision as of 02:52, 22 October 2018
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	**Response to vasopressin is diagnostic of central DI (response is indicated by urine osm >800 mOsm/L)		**Response to vasopressin is diagnostic of central DI (response is indicated by urine osm >800 mOsm/L)
	**No response is diagnostic of nephrogenic DI		**No response is diagnostic of nephrogenic DI
			*In adults, onset of central DI usually abrupt whereas onset gradual in nephrogenic DI

	==Management==		==Management==

Sabedi: /* Background */

2018-10-22T02:50:20Z

Background

← Older revision		Revision as of 02:50, 22 October 2018
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	==Background==		==Background==
	*Characterized as either:		*Characterized as either:
	**Central Diabetes Insipidus (DI)		**Central Diabetes Insipidus (or neurogenic DI)
	**~~Nephrogenic DI [Decreased production~~ of ~~anti-diuretic~~ hormone (ADH) or decreased renal sensitivity to ADH]		***Deficient secretion of antidiuretic hormone (ADH)
			**Nephrogenic DI
			***Normal ADH secretion but decreased renal sensitivity to ADH
	*Causes [[hypernatremia]]		*Causes [[hypernatremia]]

Catlee18: /* Management */

2017-04-02T21:36:59Z

Management

← Older revision		Revision as of 21:36, 2 April 2017
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	==Management==		==Management==
			*Place foley for strict I/Os
	*Volume repletion with [[normal saline]] or lactated ringers solution		*Volume repletion with [[normal saline]] or lactated ringers solution
	*Patients will be water-deprived		*Patients will be water-deprived

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-23T23:25:48Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 23:25, 23 July 2016
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	{{Hypernatremia causes}}		{{Hypernatremia causes}}

	==~~Diagnosis~~==		==Evaluation==
	*Measure serum and urine sodium while patient is water-deprived		*Measure serum and urine sodium while patient is water-deprived
	**Lack of response to water deprivation is diagnostic		**Lack of response to water deprivation is diagnostic

ClaireLewis: /* Disposition */

2016-07-13T23:06:23Z

Disposition

← Older revision		Revision as of 23:06, 13 July 2016
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	==Disposition==		==Disposition==
	*Admission for further workup and/or volume replacement		*Admission for further workup and/or volume replacement
	*Nephrology ~~f/u~~		*Nephrology follow up

	==See Also==		==See Also==

ClaireLewis: /* Management */

2016-07-13T23:06:11Z

Management

← Older revision		Revision as of 23:06, 13 July 2016
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	**Low-salt, low-protein diet		**Low-salt, low-protein diet
	**[[Hydrochlorothiazide]] 25mg BID		**[[Hydrochlorothiazide]] 25mg BID
	**Indomethacin has greater effect at reducing urine output than ibuprofen		**[[Indomethacin]] has greater effect at reducing urine output than ibuprofen

	==Disposition==		==Disposition==

ClaireLewis: /* Diagnosis */

2016-07-13T23:05:48Z

Diagnosis

← Older revision		Revision as of 23:05, 13 July 2016
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	**Lack of response to water deprivation is diagnostic		**Lack of response to water deprivation is diagnostic
	**Serum Osm >295 mOsm/L		**Serum Osm >295 mOsm/L
	*Record response to 5 units subcutaneous vasopressin		*Record response to 5 units subcutaneous [[vasopressin]]
	**Response to vasopressin is diagnostic of central DI (response is indicated by urine osm >800 mOsm/L)		**Response to vasopressin is diagnostic of central DI (response is indicated by urine osm >800 mOsm/L)
	**No response is diagnostic of nephrogenic DI		**No response is diagnostic of nephrogenic DI