To prevent dehydration while fluids are restricted, ADH allows your kidneys to decrease the amount of fluid lost in the urine.While fluids are being withheld, your doctor will measure changes in your body weight, urine output, and the concentration of your urine and blood. J Physiol.
Oral and enteral fluid is preferred if possible.
The major symptoms of central diabetes insipidus (DI) are polyuria, nocturia, and polydipsia due to the concentrating defect. Wang S, Li D, Ni M, et al.
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Kristof RA, Rother M, Neuloh G, Klingmüller D. Incidence, clinical manifestations, and course of water and electrolyte metabolism disturbances following transsphenoidal pituitary adenoma surgery: a prospective observational study. Zerbe RL, Robertson GL.
Winzeler B, Cesana-Nigro N, Refardt J, et al. Schneider HJ, Kreitschmann-Andermahr I, Ghigo E, Stalla GK, Agha A. Hypothalamopituitary dysfunction following traumatic brain injury and aneurysmal subarachnoid hemorrhage: a systematic review. Hypernatremia.
Bockenhauer D, van't Hoff W, Dattani M, Lehnhardt A, Subtirelu M, Hildebrandt F, et al. Babey M, Kopp P, Robertson GL.
A comparison of plasma vasopressin measurements with a standard indirect test in the differential diagnosis of polyuria.
When oral intake is inadequate and hypernatremia is present, replace … Follow the volume of water intake and the frequency and volume of urination, and inquire about thirst. Prevalence and risk factors for central diabetes insipidus in cardiac arrest survivor treated with targeted temperature management. Seckl J, Dunger D. Postoperative diabetes insipidus. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE3NjQ4LXRyZWF0bWVudA==
Systemic arterial vasodilation, vasopressin, and vasopressinase in pregnancy. Los EL, Deen PM, Robben JH.
Rigoli L, Lombardo F, Di Bella C. Wolfram syndrome and WFS1 gene. Arginine-stimulated copeptin measurements in the differential diagnosis of diabetes insipidus: a prospective diagnostic study.
Functional characterization of vasopressin type 2 receptor substitutions (R137H/C/L) leading to nephrogenic diabetes insipidus and nephrogenic syndrome of inappropriate antidiuresis: implications for treatments.
Krahulik D, Zapletalova J, Frysak Z, Vaverka M. Dysfunction of hypothalamic-hypophysial axis after traumatic brain injury in adults. Ananthakrishnan S. Diabetes insipidus during pregnancy.
Masri-Iraqi H, Hirsch D, Herzberg D, et al. Patients with normal thirst mechanisms can usually self-regulate.No specific dietary considerations exist in chronic DI, but the patient should understand the importance of an adequate and balanced intake of salt and water. Di Iorgi N, Napoli F, Allegri AE, Olivieri I, Bertelli E, Gallizia A, et al. Li G, Shao P, Sun X, Wang Q, Zhang L. Magnetic resonance imaging and pituitary function in children with panhypopituitarism. Because of side effects, carbamazepine is rarely used, being employed only when all other measures prove unsatisfactory. Trepiccione F, Christensen BM. Travels through deserts are best undertaken at night to avoid the excessive dehydration that can occur during day travel.After pituitary surgery, patients should undergo continuous monitoring of fluid intake, urinary output, and specific gravities, along with daily measurements of serum electrolytes.Follow the specific gravity of the urine, and administer the next dose of desmopressin when the specific gravity has fallen to less than 1.008-1.005 with an increase in urine output. Do not administer sterile water without dextrose intravenously, as it can cause hemolysis.To avoid hyperglycemia, volume overload, and overly rapid correction of hypernatremia, fluid replacement should be provided at a rate no greater than 500-750 mL/h.
Satoh M, Ogikubo S, Yoshizawa-Ogasawara A. Postoperative Diabetes Insipidus and Hyponatremia in Children after Transsphenoidal Surgery for Adrenocorticotropin Hormone and Growth Hormone Secreting Adenomas.
D'Alessandri-Silva C, Carpenter M, Ayoob R, et al.
Intravenous 5% dextrose and 0.45% sodium chloride may be necessary.
Knoers N, Lemmink H, Adam MP, et al. Diabetes insipidus (DI) is a metabolic disorder characterized by an absolute or relative inability to concentrate urine, resulting in the production of large quantities of dilute urine.
When oral intake is inadequate and hypernatremia is present, replace losses with dextrose and water or an intravenous (IV) fluid that is hypo-osmolar with respect to the patient’s serum.