Diabetes insipidus - causes, symptoms, diagnosis and treatment. How to deal with frequent urination?

Polyuria (polyuria) and oliguria (oliguria) may indicate different conditions. In case of violations of urine secretion, which lead to its increased or decreased excretion, it is necessary to consult a doctor.

A healthy adult who consumes the right amount of fluid and does not use diuretics should excrete about 1.5-2 liters of urine per day. Diabetes mellitus and polyuria of another origin is indicated by the release of more than 3 liters of urine per day. a person who consumes no more than 2-2.5 liters of liquid. Diabetes insipidus is not a commonly diagnosed disease - it affects 1 in 25,000 people. The disease is manifested by excessive excretion of fluid from the body, which can lead to dehydration.

We are dealing with oliguria, when the amount of urine produced decreases in a person taking the right amount of fluid. Oliguria causes the body to excrete no more than 0.5 liters of urine per day.

In the case of polyuria and oliguria, we can deal with different causes of disorders. Detection of changes in the amount of urine excreted, as well as its smell and color, should be the reason for a urinalysis and consultation with a specialist.

What is diabetes insipidus?

Diabetes insipidus is one of the causes of polyuria. As a result of the release of too much unconcentrated urine, electrolyte disturbances affect the functioning of the body. An increased concentration of sodium and a deficiency of other electrolytes cause, incl. neurological symptoms. Untreated diabetes insipidus can lead to coma due to dehydration.

Causes of diabetes insipidus intense thirst that is difficult to quenchdespite drinking heavily. This may be due to improper functioning of the kidneys or hormonal disorders, which are the result of disorders in the pituitary gland or hypothalamus.

The symptoms of diabetes insipidus are sometimes confused with the symptoms of diabetes. In both cases there is increased thirst and nocturnal urination. It is important to note that both diabetes insipidus and diabetes require urgent medical advice.

What affects the body’s water balance?

The kidneys are responsible for removing water from the body, the work of which is controlled by the brain, in particular the antidiuretic hormone (ADH, vasopressin), secreted by the cerebral hypothalamus and stored in the pituitary gland. Violations of the body’s water balance pose a threat to health, leading to poisoning of the body with toxins (in the case of oliguria) or dehydration and electrolyte disturbances (in the case of polyuria).

In the body of a healthy person, water-electrolyte homeostasis is maintained due to the proper functioning of the kidneys and the unimpaired regulation of their activity. However, it is worth remembering that the amount of fluid you drink, thanks to which you can hydrate the body, has a significant impact on water management in the body. By drinking too little or too much, we disturb the body’s water balance, which leads not only to a decrease or increase in urine output, but also to the appearance of unpleasant ailments, such as weakness, chronic fatigue and muscle tremors.

The water balance of the body is affected not only by the amount, but also by the type of fluid you drink. By resorting primarily to dehydrating drinks, such as coffee, tea, and diuretic herbs, we can become dehydrated even though we are drinking the right amount of fluid.

Causes of diabetes insipidus

The most common cause of diabetes insipidus is dysfunction of the posterior pituitary or hypothalamus. The secretion of vasopressin can be influenced, among other things:

• tumors of the hypothalamic-pituitary region,

• malformations of the hypothalamic-pituitary region,

• undergone neurosurgical operations.

Diabetes insipidus can also be caused by damage to the pituitary gland. People with severe head injuries and infections may struggle with a vasopressin deficiency - damage to the pituitary gland can be caused, for example, by meningitis and autoimmune inflammatory diseases.

Diabetes insipidus can also develop as a result of chronic kidney disease and kidney failure. Then, although vasopressin is released in the right amount, it does not cause the desired reaction, because the kidneys do not respond to pituitary hormones.

Both in disorders of the endocrine glands and in disorders of the kidneys, which lead to excessive excretion of urine, we can deal with a congenital or acquired disease.

If hormones are responsible for excessive urine output, central diabetes insipidus is diagnosed. In a situation where the kidneys are responsible for increased urine output, renal diabetes insipidus is diagnosed. Gestational diabetes is also sometimes diagnosed.

In about 1/3 of patients, the cause of diabetes insipidus is not detected. Then, idiopathic diabetes insipidus is diagnosed.

Symptoms of diabetes insipidus

Symptoms of diabetes insipidus include:

• increased and difficult to quench thirst,

• excretion of an increased amount of dilute urine (more than 3 liters per day) with normal fluid intake,

• low osmolality of urine, which indicates the removal of excess fluid from the body,

• symptoms of electrolyte disturbances, such as headache, muscle cramps, weakness, impaired concentration, dry skin and mucous membranes.

In addition, changes in the hypothalamus and pituitary gland can cause neurological symptoms such as visual disturbances, impaired consciousness, and muscle weakness.

What is the diagnosis of diabetes insipidus?

At the stage of diagnosing diabetes insipidus, various tests are performed. We include among others:

• general urine analysis,

• analysis of urine concentration,

• vasopressin test,

• plasma osmolality test.

Treatment of central diabetes insipidus

Central diabetes insipidus caused by vasopressin deficiency is treated with its synthetic analogue, desmopressin. Depending on the cause of diabetes insipidus, which may be due to, for example, a pituitary tumor, the underlying disease must be diagnosed and treated.

Treatment of renal diabetes insipidus

Renal diabetes insipidus requires, first of all, the identification and treatment of the underlying disease, which reduces the sensitivity of the kidneys to the action of vasopressin. Treatment is complemented by a low sodium diet.

Patients should remember to replenish fluids, as well as constantly monitor the course of the disease. Properly treated, diabetes insipidus is not life-threatening. In most cases, diabetes insipidus is a chronic disease.

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