Canis ISSN: 2398-2942

Diabetes insipidus: nephrogenic

Contributor(s): David Bruyette

Introduction

  • Inability of kidneys to respond to anti-diuretic hormone (ADH).
  • Primary nephrogenic diabetes insipidus (NDI) is congenital and very rare.
  • Cause: (secondary) renal disease, pyometra, hypokalemia, hyperadrenocorticism, hyperthyroidism, hypoadrenocorticism, hepatic failure, hypercalcemia, drugs.
  • Signs: polyuria, polydipsia.
  • Diagnosis: polydipsia, polyuria.
  • Treatment: treat underlying disease, change of diet.
  • Prognosis: poor.

Pathogenesis

Etiology

Primary NDI

  • Congenital disease, unknown cause (hereditary?).

Secondary NDI

Pathophysiology

  • Primary tubular defect or secondary lack of concentration gradient in renal medulla → failure kidneys to concentrate urine despite approriate ADH release.
  • Primary NDI: pure water loss (hyposthenuric urine) → increase in plasma sodium concentration → water moves from intracellular space to extracellular space → intracellular hypertonicity but initially extracellular fluid volume remains intact despite volume loss → eventually hypotension, renal ischemia and renal shut down.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Takemura N (1998) Successful long-term treatment of congenital nephrogenic diabetes insipdus in a dog. JSAP 39 (12), 592-594 PubMed.


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