What is central diabetes insipidus?

The article is professionally consulted by Master, Doctor Vu Thi Duyen - Department of Medical Examination & Internal Medicine - Vinmec Hai Phong International General Hospital

Vasopressin-sensitive diabetes insipidus is a condition that is caused by vasopressin deficiency or kidney resistance to vasopressin. The disease disrupts water balance and seriously affects the quality of life of patients.

Centralized diabetes insipidus is a disease that affects the body's ability to balance water. At that time, the patient's kidneys are no longer able to hold water and show a lot of urination, causing dehydration in the body. Therefore, the patient often feels thirsty, the urine is more dilute, it is easy to fall into a state of dehydration, causing the concentration of Potassium and Sodium to rise and the body to fall into an imbalance of water and electrolytes.
Diabetes insipidus is a very rare disease with an incidence of 1:25000 people and can appear at any age, including in pregnant women.

Vasopressin-sensitive diabetes insipidus is caused by two main causes:
Primary central diabetes insipidus: The disease is caused by inherited abnormalities of the vasopressin gene on chromosome 20. This is a dominant mutation. of the primary chromosome. However, many cases of diabetes insipidus have no known cause. Secondary central diabetes insipidus: The cause is secondary to a number of injuries such as pituitary surgery, traumatic brain injury, tumor on or in the pituitary gland, infection, damage to blood vessels.

Patients with vasopressin-sensitive diabetes insipidus may notice mild to severe symptoms such as the following:
The amount of urinating much more than usual can range from 3 to 20 liters/day even up to 40 liters/day. The frequency of frequent urination is continuous and each time is only about half an hour apart. Not sleeping well due to frequent waking up at night to urinate. Patients with severe dehydration: always feel thirsty, especially cold water. Due to severe dehydration, if the patient does not drink enough water lost due to urination, the patient will have symptoms of headache, dry skin, dry mouth and tongue, dizziness, cramps, lethargy, even unconsciousness . Loss of concentration, fatigue because of having to wake up many times during the night. Children with central diabetes insipidus will often cry, bedwetting at night and urinary incontinence during the day, anorexia, underweight, growth retardation...

Vasopressin-sensitive diabetes insipidus can be treated with medical methods, combined with changing the patient's lifestyle.
Diagnostic technique: to accurately diagnose vasopressin-sensitive diabetes insipidus, doctors will perform blood and urine tests. If the disease is severe, the patient will be asked to have a brain MRI and some other additional tests.
Treatment of vasopressin-sensitive diabetes insipidus: Depending on the severity of the disease, the patient will be indicated to perform the following measures:
Surgery to remove the tumor pressing on the pituitary gland: If Diseases caused by diseases of the hypothalamus-pituitary gland such as pituitary adenomas need to be treated first, such as surgical removal of the tumor. Using specific drugs: Some drugs to treat central diabetes insipidus: -Chlopropamide (Diabinese) is a hypoglycemic drug, it works to increase water reabsorption through ADH, the usual dose is 125 to 500mg per day. days, up to 4 days at maximum dose.
-Carbamazepine doses of 100 to 300 mg twice daily have been shown to increase responsiveness to ADH.
-Clofibrate dose of 500mg every 6 hours to improve polyuria due to increased release of ADH.
Control the amount of water in and out.

Notes to keep in mind to prevent severe disease progression: To control central diabetes insipidus, patients need to:
Drink only a sufficient amount of water when thirsty. Take medication for diabetes insipidus exactly as prescribed by your doctor. Inform your doctor immediately if your thirst does not stop after taking the medicine. Immediately go to the nearest medical facility when symptoms such as sweating, high fever, diarrhea, and urinating more often appear during treatment. Patients need to find a reputable medical facility for surgery if necessary. Vasopressin-sensitive diabetes insipidus, if prolonged, can seriously affect the patient's daily life. Therefore, if the above-mentioned signs are noticed, the patient should go to the doctor soon to be diagnosed and treated quickly and effectively.