Nephrogenic Diabetes Insipidus – Causes, Symptoms, Treatment

Nephrogenic diabetes insipidus is the second most common type of diabetes insipidus and is due to an insensitivity of the kidneys to antidiuretic hormone (ADH). This results in the production of large amounts of urine.

Causes of nephrogenic diabetes insipidus

"Nephrogenic diabetes insipidus is a disorder in which a defect in the small tubes (tubules) in the kidneys causes a person to pass a large amount of urine. The tubules allow water to be removed from the body or reabsorbed" (1).

The tubules of the kidneys do not respond to ADH. The normal job of ADH is to limit the amount of urine production, which helps concentrate the urine and regulate fluid levels in the body.

Nephrogenic DI can be an inherited disease but is most commonly a disorder that develops in life. Factors that can trigger the start of nephrogenic DI include:

  • A blockage in the urinary tract
  • High levels of calcium
  • Low levels of potassium
  • The use of certain medications including: lithium, demeclocycline, and amphotericin B

Symptoms of nephrogenic diabetes insipidus

Symptoms include:

  • excessive thirst or fluid intake, you may crave ice water
  • excessive urination producing large amounts of urine (usually more than 3 to 15 liters per day)

If you do not drink enough you may become dehydrated.

Nephrogenic diabetes insipidus treatment

If symptoms of diabetes insipidus are noticed you should consult with your doctor as soon as possible. Your doctor will conduct tests to determine the amount of urine you are producing, and urine concentration tests to determine if your urine is too dilute and has a low urine osmolality, which may indicate the presence of the disease.

The goal of treatment is to regulate your body’s fluid levels. You will be given large amounts of fluids to replenish what is being lost through urination.

If the condition is due to a prescription medication, your doctor may take you off the medication. You should never stop taking a medication without your doctor’s consent.

A drug called hydrochlorothiazide may be prescribed to improve symptoms. Although this drug is a diuretic, a type of drug typically used to increase urine output; in some cases of nephrogenic DI it can reduce urine output.

If you drink enough fluids, there will be no significant complications from this condition. If you do not drink enough fluids, the large volume of fluid lost through urination may result in dehydration.

(1) MedlinePlus (2010). Diabetes insipidus-nephrogenic. Retrieved from

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