In adults, nephrogenic diabetes insipidus most often develops as a result of lithium toxicity or hypercalcemia. Impairment of urinary concentration occurs in up to 20% of patients taking lithium, as a result of dysregulation of the aquaporin system in principal cells of the collecting duct.
According to the literature, the principal causes of central diabetes insipidus and their oft-cited approximate frequencies are as follows:
Idiopathic: 30%
Malignant or benign tumors of the brain or pituitary: 25%
Cranial surgery: 20%
Head trauma: 16%
Approximately 10% of central diabetes insipidus cases are familial (although some experts suggest that familial diabetes insipidus may be underdiagnosed). Hereditary nephrogenic diabetes insipidus is relatively rare. The most common inherited form results from mutations in the AVP receptor 2 gene (AVPR2) on chromosome Xq28.
The frequency with which diabetes insipidus develops after neurosurgery varies with the surgery's scope. Approximately 10%-20% of patients experience diabetes insipidus after transsphenoidal removal of an adenoma, compared with 60%-80% of those who have undergone excision of large tumors.
For more on the etiology of diabetes insipidus, read here.
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Cite this: Romesh Khardori. Fast Five Quiz: Test Your Knowledge of Diabetes Insipidus - Medscape - May 30, 2018.
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