Diabetes insipidus symptoms

August 12, 2017 17:51 | Genetic Diseases

diabetes insipidus - a disease associated with damage to the posterior lobe of the pituitary or hypothalamus with decreased secretion of antidiuretic hormone.Not to be confused with diabetes insipidus diabetes more common.Renal diabetes insipidus is characterized by renal resistance in relation to the action of antidiuretic hormone.Most often it is a hereditary disease, but can occur and acquired its shape due to the toxic effects on the kidney.This is quite a rare disease that results from insufficient production of vasopressin, which is also known as antidiuretic hormone (ADH).Vasopressin is secreted by pituitary gland in the back, helps the kidneys to reabsorb water and maintain proper fluid balance.If the pituitary gland fails to produce enough ADH, water will not be retained, but will simply pass through the kidneys and released in very large quantities.In more rare cases, the kidneys will not be able to properly respond to ADH;a disease known as diabetes insipidus.The main threat to health in any

form of diabetes is dehydration.Diabetes insipidus is equally common in men and in women.With proper treatment, the prognosis of the disease is quite favorable (except when associated with cancer).

reasons

• About a third of all cases, the cause of diabetes insipidus is unknown.

• Sometimes hereditary factors may play a role.

• Damage to the pituitary gland at the head injury, tumor or inflammation of the hypothalamus, as well as radiation therapy or surgery can lead to diabetes insipidus.

• The most common cause of nephrogenic diabetes insipidus is a therapy with lithium.

primary urine passes through the proximal convoluted tubules in the loop of Henle.In ascending loop of Henle department carried out an active reuptake (reabsorption) of sodium, and other osmotically active substances, whereby the kidney parenchyma create a high level of osmotic pressure.Free water by osmosis laws can move from the lumen of the tubules through their wall in the direction of the high osmotic pressure, however tubule permeability changes allow you to adjust the process.Regulatory role is played by the antidiuretic hormone, produced in the posterior lobe of the pituitary gland.Its effect on the permeability of the distal tubules of the water is that under his influence she undergoes intensive reabsorption and decreases the amount of daily urine.Cessation or reduction of the secretion of antidiuretic hormone activity leads to the fact that the tubular walls are impermeable to water, the amount of daily urine increases substantially.

Symptoms

Hereditary forms of diabetes insipidus occur in the first 3-6 months of life, although breastfeeding clinical symptoms appear later than in children who are at an early artificial feeding.This is due to the higher (2-3 times) concentration of osmotically active compounds and ions in cow's milk compared with women.The daily amount of urine, even in an infant reaches 2 liters or more.

first symptoms - fever (fever salt) and lack of weight gain, leading to weight loss and loss of body fluids.A baby's skin is characterized by dryness and marble, there are constipation, vomiting.The feeling of thirst in an infant does not appear, so many children are exposed to unnecessary diagnostic tests and antibiotics.The progression of degeneration and increase the number of lost fluid lead to violations of mental development, in addition, contribute to intracranial hemorrhage and organic brain damage.Many children have frequent urine output, hyperactivity, lack of attention, concern.The behavior is somewhat improved when the child's thirst is satisfied.Urine output is 10-12% of the filtered plasma (about 1% of normal).

• Frequent and excessive urination.urine output can reach 23 to 33 liters for 24 hours and can occur every 30 minutes, even at night.

• Very strong thirst.

• Dry skin.

• Constipation.

• Distinct signs of dehydration, including dizziness, weakness, and unconsciousness.

Diagnostics

• necessary physical examination and medical history.The diagnosis of diabetes insipidus suggest that the patient reports an unusually frequent urination with higher urine output.

• Urinalysis is done in order to determine the presence of urine dilution (low density of urine).

• sample can be carried out with a water load.The patient does not consume any fluid within eight hours, during which the volume and density determine urine output.Patients with diabetes insipidus continue to produce large amounts of urine, despite dehydration.In patients with diabetes insipidus associated with insufficient work of the pituitary, vasopressin administration reduces the amount of urine and the urine becomes concentrated (as opposed to patients with nephrogenic diabetes insipidus).

• Can be carried out blood tests to determine the water-salt balance.

sample with vasopressin (or synthetic analogues) has no effect on the concentration of urinary osmolarity (no more than 100 osmol / kg) and a decrease in urine output, which confirms the diagnosis of renal diabetes insipidus.The normal response to vasopressin is associated with the activation of membrane adenylate cyclase and increased cAMP excretion in the urine, which is not observed in renal diabetes insipidus.renin activity in plasma of patients can be improved, the level of aldosterone in the lower normal limits.Kidneys are macroscopically not changed, but the histological examination revealed a shorter proximal convoluted tubules.From the perspective of the pathophysiology of polyuria should distinguish 3 types: impaired secretion of ADH, depression osmoreceptors and thirst, defects in renal mechanisms of urine concentration.

Treatment

• Can be used vasopressin (ADH synthetic) in the form of nasal sprays, pills or injections to replace or supplement the production of ADH by the body.This hormone therapy is usually necessary to prolong life, but if diabetes insipidus is caused by head injury or surgery, the treatment may be interrupted.

• For the treatment of nephrogenic diabetes insipidus, your doctor may recommend a diet low in salt to reduce hunger and slow down the excretion of water.Also, some diuretics, drugs (nephrogenic diabetes insipidus is not treatable using ADH) may be prescribed.

• Drink plenty of fluids to prevent dehydration.

• Eat fiber foods and plenty of fruit juices to prevent constipation.

Prevention

• Methods for the prevention of diabetes insipidus are not known.

• Contact your doctor immediately if you develop symptoms of diabetes insipidus.

• Attention!Call the "ambulance" if you see the person next to you loses consciousness.