From the Guidelines
Diabetes insipidus is caused by problems with either the production or action of antidiuretic hormone (ADH), also called vasopressin, and can be classified into two main types: central diabetes insipidus and nephrogenic diabetes insipidus. The production of ADH is typically controlled by the brain's pituitary gland, and any damage to this gland, such as from surgery, head trauma, tumors, or autoimmune diseases, can lead to central diabetes insipidus 1. On the other hand, nephrogenic diabetes insipidus occurs when the kidneys do not respond properly to normal levels of ADH, often caused by chronic kidney disease, certain medications like lithium, genetic disorders, or electrolyte imbalances 1.
Some key causes of diabetes insipidus include:
- Damage to the pituitary gland or hypothalamus, which can be caused by surgery, head trauma, tumors, or autoimmune diseases
- Genetic disorders, such as congenital nephrogenic diabetes insipidus
- Certain medications, such as lithium, which can affect the kidneys' ability to respond to ADH
- Electrolyte imbalances, which can disrupt the normal functioning of the kidneys
It's worth noting that diabetes insipidus is a distinct condition from diabetes mellitus, which is caused by problems with insulin production or action, rather than ADH production or action 1.
In terms of diagnosis and treatment, genetic testing can provide an early and definite diagnosis of congenital nephrogenic diabetes insipidus, and can help identify patients with partial insensitivity to ADH 1. Treatment depends on the specific type and cause of diabetes insipidus, but may include desmopressin (DDAVP) for central diabetes insipidus, or addressing underlying causes and using thiazide diuretics for nephrogenic diabetes insipidus.
From the Research
Causes of Diabetes Insipidus
The causes of diabetes insipidus can be categorized into two main types: central and nephrogenic diabetes insipidus.
- Central diabetes insipidus is characterized by a deficiency of antidiuretic hormone (ADH) secretion from the posterior pituitary gland 2, 3.
- Nephrogenic diabetes insipidus is characterized by the kidney's inability to respond to ADH 2, 3.
Underlying Causes
The underlying causes of diabetes insipidus can be attributed to various factors, including:
- Inadequate secretion of ADH from the posterior pituitary gland 4
- Insufficient renal response to adequate levels of ADH 4
- Dysfunction of the neurohypophysis (central diabetes insipidus) 5
- Renal vasopressin resistance (nephrogenic diabetes insipidus) 5
- Tumoral or infiltrative damage to the neurohypophysis 5
- Certain medical conditions, such as renal disease, cerebral trauma, and surgical patients 4
Other Forms of Diabetes Insipidus
There are also other forms of diabetes insipidus, including: