Management of Nephrogenic Diabetes Insipidus: An Overview

Abstract

Diabetes insipidus is a disorder in which the collecting tubules are impermeable to water provoking the excretion of large amounts of diluted urine. In central diabetes insipidus, the release of antidiuretic hormone is decreased, while in nephrogenic diabetes insipidus, the response of the kidneys to this hormone is defective. Common clinical manifestations include polyuria, nocturia, and polydipsia. Laboratory findings show electrolytic imbalance, particularly hypernatremia. Diagnosis can be determined by a hypertonic saline infusion and water deprivation test. In addition to a thorough medical history and physical examination, lab tests and imaging procedures are commonly required. Treatment strategies include diet restrictions, hydration, thiazide diuretics, indomethacin, chlorthalidone, amiloride, and desmopressin. The management of this disorder is facilitated by combining various therapies and considering contraindications to each treatment. However, further studies are necessary to develop safer and more effective medications to manage this complex condition.