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3.12.3 - Diabetes Insipidus and Other Polyuric Syndromes

from Section 3.12 - Endocrine Disorders

Published online by Cambridge University Press:  27 July 2023

By
Thomas Leith
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Polyuria is generally defined as urine output of >3 l/day in an adult of normal mass.

  2. 2. Water diuresis refers to the passage of large amounts of dilute urine, secondary to diabetes insipidus or primary polydipsia.

  3. 3. Solute diuresis is characterised by excess urinary solute, commonly due to hyperglycaemia or azotaemia or following the use of loop or osmotic diuretics.

  4. 4. Cranial diabetes insipidus is characterised by polyuria with a urine concentrating defect, due to a relative or absolute deficiency of arginine vasopressin (AVP).

  5. 5. Nephrogenic diabetes insipidus is characterised by polyuria due to renal resistance to the anti-diuretic effects of AVP.

Keywords

polyuriadiabetes insipidusanti-diuretic hormone
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 384 - 386
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Bhasin, B, Velez, JC. Evaluation of polyuria: the roles of solute loading and water diuresis. Am J Kidney Dis 2016;67:507–11.CrossRefGoogle ScholarPubMed
Bockenhauer, D, Bichet, DG. Pathophysiology, diagnosis and management of nephrogenic diabetes insipidus. Nat Rev Nephrol 2015;11:576.CrossRefGoogle ScholarPubMed
Fenske, W, Allolio, B. Current state and future perspectives in the diagnosis of diabetes insipidus: a clinical review. J Clin Endocrinol Metab 2012;97:3426–37.CrossRefGoogle Scholar
Robertson, GL. Diabetes insipidus: differential diagnosis and management. Best Pract Res Clin Endocrinol Metab 2016;30:205–18.CrossRefGoogle ScholarPubMed
Timper, K, Fenske, W, Kühn, F, et al. Diagnostic accuracy of copeptin in the differential diagnosis of the polyuriapolydipsia syndrome: a prospective multicenter study. J Clin Endocrinol Metab 2015;100:2268.CrossRefGoogle ScholarPubMed

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