Nephrogenic diabetes insipidus is a disorder where the kidneys cannot conserve water, instead expressing large amounts of very dilute urine. Although it shares a name with diabetes mellitus, this condition has nothing to do with glucose and insulin; the two conditions have a similar name because both tend to cause thirst and urine overproduction. A number of options for management and treatment are available, depending on the cause.
In patients with nephrogenic diabetes insipidus, the kidneys are not sensitive to antidiuretic hormone, the chemical the body produces to tell the kidneys to conserve water. Water passes through the kidneys freely and is eliminated. This can lead to dehydration, potentially causing serious complications like brain damage and injuries to other organs. Especially in the heat or during heavy exercise, patients can be at serious risk because their bodies lack the ability to save water.
Patients with nephrogenic diabetes insipidus can experience symptoms like extreme thirst, frequent urination, headaches, and fatigue. Blood testing may show imbalances in electrolyte levels and urine samples will be extremely dilute, containing large amounts of water. Additional testing can be used to learn more about why the patient has developed nephrogenic diabetes insipidus so appropriate treatments can be provided. This testing can include more bloodwork, urine testing, and a thorough patient interview to identify risk factors in the patient's medical history, including a known family history of diabetes insipidus.
Sometimes this condition is genetic, occurring mostly in males. Other patients acquire it, usually as a response to medications or a urinary blockage. In both cases, patients need to be provided with ample supplies of water to keep the electrolytes in balance, and access to a restroom is also necessary so the patient can urinate as needed. If the condition is being caused by an underlying medical problem, changing medication regimens or treating the blockage may resolve the nephrogenic diabetes insipidus and allow the patient to return to normal health.
People with incurable forms of this condition need to be very careful about water consumption. It is important to drink well when thirsty and while in very hot climates. Water lost through sweat and urination cannot be conserved by the kidneys and the body's electrolytes can rapidly become too concentrated. Water should be carried at all time and in environments where drinking is usually prohibited, like libraries, patients should request to be allowed to use a water bottle. Legally, reasonable accommodations like access to fresh water for patients with medical conditions cannot be denied.
