Diabetes insipidus is a pathology that is accompanied by a violation of the synthesis of antidiuretic hormone or susceptibility to it. As a result, the natural course of reabsorption processes in the renal tubules changes. This disease is diagnosed in both sexes, regardless of age (children are also susceptible to the disease).
Of course, many people are looking for more information. What is pathology and what symptoms are accompanied by? What is the difference between diabetes and diabetes insipidus? What are the causes of the development of the disease? Are there effective treatments? How dangerous is pathology? The answers to these questions are important.
What is pathology?
Diabetes insipidus is a pathology that is relatively rare. However, she is dangerous. The disease is associated with a deficiency of antidiuretic hormone or with a decrease in the sensitivity of the kidney tissues.
Vasopressin (antidiuretic hormone) is synthesized by the hypothalamus and accumulates from the backpituitary. This substance is extremely important for normal life, as it regulates the water balance and controls the osmotic composition of internal fluids (including blood).
With a deficiency of this hormone or insensitivity to it, the intensity of fluid reabsorption processes in the renal tubules decreases. As a result, more volumes of low-density urine are excreted from the body. The body tries to compensate for the lack of fluid, creating a feeling of constant thirst.
Both men and women are equally affected by this disease. By the way, cases of such a violation are also recorded in veterinary practice (diabetes insipidus occurs in dogs and other pets).
Varieties of disease
Depending on the causes, in modern medicine there are two types of diabetes insipidus:
- Central - associated with impaired synthesis of vasopressin. This form of pathology can be idiopathic (the causes of the disease are not completely clear to the medical community, but are usually associated with a genetic predisposition) or symptomatic (develops against the background of brain injuries, operations on the hypothalamic-pituitary system, brain infections).
- Renal form is associated with a violation of the sensitivity of kidney tissue to the effects of antidiuretic hormone.
Causes of the central form of diabetes
If we talk about the central form of pathology, which is associated with a violation of the synthesis of antidiuretic hormone instructures of the brain, then the list of reasons includes:
- tumors in the hypothalamus and pituitary (both benign and malignant);
- complications after neurosurgical operations (quite often the removal of a pituitary adenoma leads to disruption of the processes of synthesis and release of vasopressin);
- inflammation of the membranes of the brain;
- traumatic brain injury;
- cerebrovascular disorders, such as malnutrition of the hypothalamic-pituitary system;
- spread of metastases in oncological diseases to certain brain structures;
- syphilis (in this case, the infection often affects the central nervous system);
- there is a genetic predisposition;
- rarely, infections, for example, influenza, SARS, lead to the development of such a disease.
Renal pathology: risk factors
If we are talking about a violation of the sensitivity of the renal tissues to antidiuretic hormone, then the list of reasons looks different:
- most often caused by a congenital sensory disorder;
- diseases that are accompanied by damage to the tubules or medulla of the kidney;
- sickle cell anemia;
- amyloidosis or polycystic kidney disease;
- chronic forms of kidney failure;
- a sharp increase or decrease in the level of calcium in the blood;
- taking certain medications, including Demeclocilin, lithium preparations;
- krisk factors include malnutrition and advanced age.
It is worth noting that in about 30% of cases, the cause of the development of diabetes insipidus cannot be found out.
What symptoms should I look out for? Features of the clinical picture
Signs of diabetes insipidus may appear suddenly or their intensity increases gradually. The daily volume of urine increases sharply - up to 3-15 liters. The patient is tormented by constant thirst. Since a large amount of liquid constantly enters the stomach, it gradually stretches, and sometimes sinks. Water deficiency affects the synthesis of digestive enzymes, as a result of which a sick person loses his appetite, suffers from nausea and constipation. It is also possible the development of gastritis and colitis.
External signs of dehydration also appear - the skin and mucous membranes become dry. The patient loses body weight and often complains of dry mouth. The intensity of perspiration decreases. Patients suffer from constant fatigue. Possible heart rhythm disturbance, lowering blood pressure.
Excessive urination torments a person at night. Lack of sleep affects the emotional state. Mental activity decreases, patients complain of insomnia. Symptoms include increased irritability, neurosis, psychosis. Diabetes insipidus in women is sometimes accompanied by menstrual irregularities and further development of infertility.
Features of the disease in childhood
Diabetes insipidus in children is also recorded quite often. The clinical picture in children older than three years is accompanied by approximately the same symptoms as in adults, although it is more blurred. The child has bedwetting, poor appetite, vomiting after eating, chronic constipation. Some guys complain of joint pain. If the disease is not diagnosed on time, then a significant delay in mental and mental development is possible.
Diabetes insipidus in newborns is even more severe. As a rule, the baby quickly loses weight, his body temperature can either rise or drop unexpectedly. The child is restless, often cries, but there are no tears (or there is little liquid). Urination occurs frequently, with a large amount of fluid.
The skin gradually loses elasticity, which is associated with gradual dehydration. There is frequent vomiting. During the examination, the doctor notes an increase in heart rate. Unfortunately, an infant cannot communicate its thirst. Dehydration can lead to seizures and sometimes death. That is why symptoms should never be ignored.
Possible Complications
Diabetes insipidus responds well to treatment. But in the absence of therapy, a violation of the water and electrolyte balance is fraught with dangerous complications. First of all, the pathology affects the work of the cardiovascular system - patients develop various forms of arrhythmias, hypertension.
Perhaps andnervous system disorder. Patients who have not received proper treatment often suffer from sleep disorders, depression, nervousness and other mental disorders.
Diabetes insipidus in men can lead to problems with achieving an erection, sometimes even impotence. If a person consumes less liquid than is excreted by the kidneys, then dehydration occurs, which is accompanied by severe weakness, blood clots, convulsions, a sharp decrease in blood pressure, which often ends in collapse.
diabetes insipidus: diagnosis
If you have the above symptoms, you should consult a doctor. As a rule, at the time of taking an anamnesis, a specialist can already suspect diabetes insipidus. Urine is excreted in large quantities (more than 3 liters per day), patients complain of intense thirst and nocturnal urge to urinate. In the future, additional analyzes are carried out:
- tests are carried out to determine the osmolarity of blood and urine, it is also important to determine the level of nitrogen, calcium, sodium, sugar and urea;
- determine the relative density of urine;
- Echoencephalography is mandatory;
- radiography of the Turkish saddle, magnetic resonance and computed tomography are performed in order to detect damage to the hypothalamic-pituitary system;
- required also kidney ultrasound and excretory urography.
Central diabetes insipidus treatment
If the volume of urine excreted per day does not exceed 4 liters, then therapy may evennot required - the patient is only advised to maintain a balance of fluid intake and regularly take tests.
In other cases, doctors usually prescribe Minirin, which contains synthetic vasopressin. The dosage is selected individually. Drugs such as Miscleron and Carbamazepine stimulate the production of antidiuretic hormone. If the patient has combined diabetes and diabetes insipidus, the drug Chlorpropamide is introduced into the treatment regimen.
Treatment of the renal form of pathology
If we are talking about the renal form of the disease, then patients are prescribed diuretics, in particular Triampur, Hydrochlorothiazide. These drugs interfere with the adsorption of chlorine by the urinary tubules, resulting in increased reabsorption of water.
Sometimes anti-inflammatory drugs such as Aspirin and Ibuprofen are included in the treatment regimen.
Symptomatic therapy is also carried out. For example, treatment of diabetes insipidus in women may include measures to restore a normal menstrual cycle or treat infertility.
Proper diet
Regardless of the causes of diabetes insipidus, its form and severity, therapy necessarily includes a diet. An appropriate diet helps to cope with thirst and increased urination, as well as replenish the nutrients that the body loses with fluid. Here are some rules:
- First, you need to sharply limit the amount of s alt consumed (no more than 4-5 g per day). At the same time, the dishit is recommended to s alt after its preparation, and not in the process.
- Dried fruits must be included in the diet, as they are rich in potassium. This mineral enhances the synthesis of vasopressin.
- Doctors recommend giving up alcoholic beverages and sweets, as these products only increase thirst.
- The diet should include berries, vegetables, fruits (fresh), milk and dairy products. Fruit drinks, unsweetened compotes, freshly squeezed juices are suitable for drinking.
- It is important that the brain receives enough phosphorus, so seafood, lean fish should be present in the daily menu. You can occasionally take fish oil capsules.
- The diet should contain fats and carbohydrates, but the amount of protein should be limited, as this increases the load on the kidneys. Lean meats and eggs are allowed (but in reasonable amounts).
Traditional medicine
Some plants have healing properties that can be used to correct the functioning of the body. For example:
- An infusion of burdock roots will help to cope with thirst. 60 g of raw materials (sold in a pharmacy) should be placed in a thermos and pour a liter of boiling water. The mixture is left overnight, after which we filter. You need to drink three times a day for 2/3 cups.
- For the same purpose, tea from young walnut leaves is also used, which is not difficult to get. Pour a teaspoon of crushed leaves with a glass of boiling water and insist. Tool is ready foraddicting.
- To cope with irritability, insomnia and neurosis can tinctures of valerian and motherwort, which are sold in almost every pharmacy.
Prognosis for patients
What can a patient who has been diagnosed with diabetes insipidus expect? Treatment in this case gives good results. If the cause of a hormonal failure is a tumor in the brain or an infection, then with the right treatment regimen (for example, surgery), it is possible to get rid of the problem forever.
But in the vast majority of cases, diabetes insipidus is persistent. With properly organized treatment, it is possible to maintain a normal quality of life and even the patient's performance. Complications (including deadly ones) are recorded only if the person has not been provided with appropriate assistance.
