Nephrogenic diabetes insipidus is a long name for an uncommon condition. Nephrogenic diabetes insipidus is not the same as diabetes mellitus. Diabetes mellitus causes elevated blood sugar levels. But nephrogenic diabetes insipidus is due to a problem in the kidneys.
In nephrogenic diabetes insipidus, the kidneys can't respond to a hormone that regulates fluid balance. Excessive urination and thirst are the results. Nephrogenic diabetes insipidus can be challenging to treat.
If not controlled, diabetes can cause a host of complications that can affect nearly every organ in the body. Diabetes complications include:
Diabetes insipidus is caused by problems related to a hormone called antidiuretic hormone or ADH. ADH is produced in a part of the brain called the hypothalamus. It's stored in the pituitary gland. Release of ADH is triggered by fluid loss or dehydration. When it's released, it causes the kidneys to retain water. This results in a decrease and concentration of urine.
In nephrogenic diabetes insipidus, enough ADH is produced. But the kidneys are partially or completely blind to it. Typically, the kidneys' ADH sensors are missing or defective. As a result, ADH flows by without effect. The kidneys don't absorb enough water. Instead, they excrete abundant dilute urine as if no ADH were present.
What are the symptoms of nephrogenic diabetes insipidus?
The lack of ability by the kidneys to conserve water leads to the symptoms of nephrogenic diabetes insipidus. They include:
Excessive urine production (polyuria).
In some people, these symptoms can become extreme and cause dehydration. Excessive fluid losses can also cause electrolyte imbalances. Symptoms of electrolyte imbalances include:
For someone without nephrogenic diabetes insipidus, the extreme thirst it creates can be hard to understand. Some people need to drink a large glass of liquid every 15 minutes, all day, every day. And since the kidneys aren't holding that water in, that means a lot of bathroom breaks.
But why "insipidus"? People with diabetes insipidus aren't insipid, but their urine is. Insipid can mean dull or lacking flavor. Believe it or not, doctors long ago would taste urine to detect illness. Unlike diabetes mellitus, which results in sweet tasting urine, diabetes insipidus creates watery, flavor-free urine.
What are the causes of nephrogenic diabetes insipidus?
In infants, nephrogenic diabetes insipidus is most commonly caused by an inherited genetic mutation present at birth. As a result, the receptor for ADH doesn't function properly.
In adults who develop nephrogenic diabetes insipidus, genetics aren't the cause. Instead, medicines or electrolyte abnormalities cause the condition. Causes of nephrogenic diabetes insipidus in adults include:
Lithium, a drug most commonly taken for bipolar disorder; up to 20% of people taking lithium will develop nephrogenic diabetes insipidus.
Other medicines, including demeclocycline (Declomycin), ofloxacin (Floxin), orlistat (alli, Xenical), and others
High levels of calcium in the blood (hypercalcemia)
Kidney disease, especially polycystic kidney disease
The other form of diabetes insipidus is known as central diabetes insipidus. In central diabetes insipidus, the kidneys function normally, but not enough ADH is produced in the brain. Central diabetes insipidus has similar symptoms to nephrogenic diabetes insipidus. However, central diabetes insipidus can be treated by replacing ADH with a medication called desmopressin.
Get the latest Diabetes newsletter delivered to your inbox!
Your level is currently
If the level is below 70 and you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.
People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.
Congratulations on taking steps to manage your health.
However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.
Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.
Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.
One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.
Thank you for signing up for the WebMD Diabetes Newsletter!
You'll find tips and tricks as well as the latest news and research on Diabetes.
Did You Know Your Lifestyle Choices
Affect Your Blood Sugar?
Use the Blood Glucose Tracker to monitor
how well you manage your blood sugar over time.