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26: Diabetes Insipidus
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Published:May 2023
Roger Nicome, MD, FAAP, Julio D. Ortiz, MD, FAAP, "Diabetes Insipidus", Caring for the Hospitalized Child: A Handbook of Inpatient Pediatrics, American Academy of Pediatrics Section on Hospital Medicine, Jeffrey C. Gershel, MD, FAAP, Daniel A. Rauch, MD, FAAP, SFHM
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Diabetes insipidus (DI) is classified as either central, which results from a deficiency of antidiuretic hormone (ADH), or nephrogenic, which is secondary to insensitivity to ADH in the kidneys. Both etiologies prevent water reabsorption in the kidneys, leading to hypotonic polyuria. Central DI is caused by genetic defects, congenital abnormalities (septo-optic dysplasia, holoprosencephaly), disruptions in hypothalamic-pituitary ADH production (trauma, neoplasms, infections, autoimmune disorders), or idiopathic causes. Nephrogenic DI may be genetic, idiopathic, or acquired, including kidney disease (chronic renal failure, pyelonephritis, obstructive uropathy, polycystic kidney disease), medications (amphotericin B, gentamicin, lithium), and electrolyte disorders (hypokalemia, hypercalcemia).
The patient may present...
