Case of the Month #48 Nephrogenic DI

Published 25/04/2024

What are the types, mechanisms and causes of Diabetes Insipidus (DI)?

1. Nephrogenic DI (NDI) -  

Mechanism:  Insensitivity (Resistance) of the kidney to antidiuretic hormone (ADH).  

Causes: Lithium toxicity, Hypercalcaemia, Hypokalaemia, Hypoproteinaemia, Post-obstructive Diuresis, Renal Transplantation, Amyloidosis, Multiple Myeloma, Sickle Cell Disease, Pyelonephritis, Congenital.  

Other Drugs (Amiodarone, Amphotericin B, Clozapine, Colchicine, Demeclocycline, Foscarnet, Gentamicin, Loop Diuretics, Rifampicin) 

 

2. Cranial/central/hypothalamic/neurogenic DI (CDI) –  

Mechanism: Reduced or absent production of ADH.  

Causes: Brain Tumour, Head Injury, Neurosurgical, Hypoxic Brain Injury, CNS Infection 

 

3. Gestational DI – Increased placental vasopressinase production or as a variant of central or NDI developing during pregnancy.