Not many people know that diabetes insipidus and diabetes mellitus are two different terms are not synonymous to each other. Diabetes insipidus is mainly caused due to the problems in the kidney and the main hormone responsible for the same is the anti diuretic hormone or the vasopressin. In this article, we shall deep dive and know more about one particular type of diabetes insipidus which is known as nephrogenic diabetes insipidus.

So, come and join in for the article “Nephrogenic diabetes insipidus: Its Symptoms, Causes, Treatment, and Diet.”

What is Nephrogenic Diabetes Insipidus?

Diabetes Insipidus is a condition that is related to the inefficient functioning of the antidiuretic hormone produced by the hypothalamus. Whenever the body experiences any type of fluid loss, the antidiuretic hormone is released and allows the kidney to retain the water. However, in nephrogenic diabetes insipidus, the kidneys fail to respond appropriately to the hormone. Hence, the kidneys do not retain or absorb enough water and as a result, alarge volume of dilute urine is produced by the organ.

There are two main types of nephrogenic diabetes insipidus

Acquired nephrogenic diabetes insipidus which is caused by several factors mostly related to the lifestyle of an individual and Hereditary nephrogenic diabetes insipidus which, as the name suggests, is a condition that is carried out through various gene mutations.

Causes of Nephrogenic Diabetes Insipidus

The causes of the disease include:

• Increased levels of calcium in the patient’s blood
• Hypokalemia or extremely low levels of potassium
• When a patient has a kidney disease such as sickle cell anemia, polycystic kidney disease, medullary sponge kidney, etc.
• Nephrogenic diabetes insipidus is also known to occur in patients when they suffer from severe infections such as amyloidosis, Sjogren syndrome, amongst others
• When a patient is taking medicines that is likely to cause damage. Examples include lithium, ofloxacin, orlistat, amongst others.
• Finally, there could be hereditary reasons that can cause nephrogenic diabetes insipidus. The gene that can cause the condition is generally carried by the X chromosome.

Symptoms of Nephrogenic Diabetes Insipidus

Following are the signs and symptoms of the condition

• Patients experience excessive thirst and the condition is also called polydipsia
• Polyuria or excretion of the large volume of urine is another warning sign. In fact, few patients are even known to excrete as high as 20 liters of urine each day
• Dehydration
• Irritation in the patient
• Weakness in the body
• Feeling lazy at all times
• Pains in different muscles of the body

How is the Condition Diagnosed?

There are various ways in which the disease can be diagnosed. The following explains a few of them:

• If a person has polyuria or polydipsia, blood and urine tests are performed to diagnose the condition.
• Blood test helps to determine the amount of sodium in the blood as well the quantity of plasma. If there is an increased level of both, you might be affected with nephrogenic diabetes insipidus
• A water deprivation test is also performed to see if the person suffers from nephrogenic diabetes insipidus. The patient has to stay without water for around five hours or more and then the plasma concentration, as well as the volume of urine, is measured. In case the test is positive for nephrogenic diabetes insipidus, the patient will be resistant to the anti diuretic hormone. Hence, after the test, although the patient is dehydrated, dilute urine and blood plasma will still be present in the patient.
• A urine test in order to determine the total quantity of urine is also used to identify the occurrence of nephrogenic diabetes insipidus.
• Sometimes, an ultrasound is also performed to examine if the kidney, the urinary tract, or the bladder of the patient has swollen or not

Are Their Treatments Available?

In case of nephrogenic diabetes insipidus, since the kidneys do not respond adequately to the anti diuretic hormones, the treatment of the disease becomes absolutely difficult. However, a few known ways of treating the condition include the following:

• Experts recommend a few drugs that help to lower the volume of urine. Some of the drugs include ibuprofen, Indocin, Naprosyn, etc.
• A few doctors also recommend medicines such as hydrochlorothiazide and amiloride which are also known as “water pills” and go a long way in decreasing the total volume of urine in a patient.
• In order to avoid the problem of dehydration, the patient should always make it a point to keep himself or herself hydrated at all times.
• It is to be ensured that the patients with such a condition should always have access to the bathroom as well as water. Regular bathroom breaks should be taken by the patient of nephrogenic diabetes insipidus.
• Doctors also recommend diuretics such as thiazide diuretics and amiloride as these drugs go a long way in limiting the total output of urine
• If you are someone who has the condition of acquired nephrogenic diabetes insipidus, there is a great possibility that the same is caused due to the intake on lithium. In such a case, the patients may be advised to take amiloride as that enables to reduce the total concentration of lithium.
• Genetic testing is also performed to see that whether the child carries the genes that might lead to Nephrogenic diabetes insipidus. This is helpful because if diagnosed and treated early, the decline in health caused by dehydration can be limited.
• In children who have the history of dehydration, delay in the development, etc. are given therapies in order to limit the damages that might have been caused.
• Finally, diet also plays a big role in treating or even preventing the occurrence of Nephrogenic diabetes insipidus. The following paragraph explains more about the diet that is highly recommended for a condition such as nephrogenic diabetes insipidus

Role of Diet in Nephrogenic Diabetes Insipidus

Diet plays a very important role when it comes to the treatment of a condition like Nephrogenic diabetes insipidus. Following are a few recommended guidelines as far as the diet is concerned in order to control this type of diabetes insipidus:

• The patient should always choose a diet that is low on the total quantity of sodium. This shall go a long way in controlling the total output of urine excreted by the patient. Besides, this also helps in improving the effectiveness of thiazide diuretics in reducing the total excretion of urine
• Similarly, a low protein diet is also highly recommended.

We hope that the above post has been helpful in educating you about the condition nephrogenic diabetes insipidus, its meaning, causes, symptoms, and the treatment. Although not completely curable, the condition can be controlled with proper medication as well as lifestyle changes!