- high or high normal plasma osmolality with low urine osmolality ( low osmolality in primary polydipsia)
- high 24-hour urine volume
- failure of urinary concentration with fluid deprivation
- if fluid deprivation causing urine osmolality > 300mOsm/kg, it suggest primary polydipsia ;
if not, it is either nephrogenic or cranial diabetes insipidus
Nephrogenic DI
- renal tubules are resistant to normal or high levels of plasma vasopressin
- causes : drugs (lithium, demeclocycline, glibenclamide), hypercalcemia, sickle cell disease, hypokalemia
- treatment: amiloride
Cranial DI
- causes: hypothalamic-pituitary surgery, Wolfram syndrome, meningitis, craniopharyngioma
- treatment: synthetic vasopressin analogue desmopressin (intranasal, oral or IM)
ReplyDeleteI was diagnosed as HEPATITIS B carrier in 2013 with fibrosis of the
liver already present. I started on antiviral medications which
reduced the viral load initially. After a couple of years the virus
became resistant. I started on HEPATITIS B Herbal treatment from
ULTIMATE LIFE CLINIC (www.ultimatelifeclinic.com) in March, 2020. Their
treatment totally reversed the virus. I did another blood test after
the 6 months long treatment and tested negative to the virus. Amazing
treatment! This treatment is a breakthrough for all HBV carriers.