Do I have diabetes insipidus given my transient impaired renal function after consuming red meat?

No, You Do Not Have Diabetes Insipidus

Your transient creatinine elevation after eating red meat is a well-recognized laboratory artifact from dietary protein intake and has absolutely nothing to do with diabetes insipidus. This is a completely different physiological phenomenon.

Why Your Lab Results Changed After Red Meat

• Dietary protein, particularly red meat, causes transient increases in serum creatinine through increased creatinine production from muscle metabolism, not through actual kidney dysfunction 1
• Your creatinine rose from normal to 1.27 mg/dL within 1-3 hours of red meat consumption, then normalized the next day—this rapid fluctuation is characteristic of dietary interference, not true kidney disease 1
• The eGFR calculation is derived from creatinine, so when creatinine artificially rises, eGFR artificially falls—your eGFR of 48 was a mathematical artifact, not real kidney function 1

What Diabetes Insipidus Actually Is

Diabetes insipidus is a disorder of water balance characterized by massive hypotonic polyuria (typically >3 liters/day), extreme thirst, and inappropriately dilute urine (osmolality <200 mOsm/kg), combined with high-normal or elevated serum sodium 2, 3

Key diagnostic features you would have if you had diabetes insipidus:

• Polyuria producing 3-20+ liters of urine per day, with individual void volumes so massive they cause "bed flooding" and require "double nappies" in children 4
• Urine osmolality <200 mOsm/kg H₂O despite elevated serum sodium 2
• Constant, unrelenting thirst with craving for cold water 5
• Serum sodium that is high-normal or frankly elevated (>145 mmol/L), not normal 2

Why Your Situation Is Completely Different

• You had a transient creatinine elevation that resolved in 24 hours—diabetes insipidus causes persistent polyuria and does not affect creatinine levels 2, 3
• Diabetes insipidus is diagnosed by measuring serum sodium, serum osmolality, and urine osmolality simultaneously, not by creatinine or eGFR 2
• Your kidney function returned to normal the next day, which would never happen with true diabetes insipidus, as it is a chronic condition requiring ongoing treatment 6

The Actual Relationship Between Protein and Kidney Function

• High protein intake (>20% of daily calories) can accelerate kidney damage in patients with pre-existing diabetic kidney disease through glomerular hyperfiltration and increased intraglomerular pressure 1
• However, normal protein intake (15-20% of energy) does not cause kidney disease in people with normal kidney function 1
• The transient creatinine rise you experienced is a measurement artifact from increased creatinine production, not actual kidney damage 1

What You Should Actually Do

• Avoid eating red meat or high-protein meals within 24 hours before kidney function testing to prevent falsely elevated creatinine results 1
• If you have diabetes, maintain protein intake at 0.8 g/kg body weight per day as recommended for the general population 1
• Monitor for true signs of diabetes insipidus only if you develop massive polyuria (>3 L/day), extreme thirst, and elevated serum sodium—none of which you have described 2

Your lab abnormality was a dietary artifact that self-resolved, not a disease process requiring treatment or further evaluation for diabetes insipidus.