Pediatric Central Diabetes Insipidus
Diabetes insipidus is a rare condition in which the kidneys are unable to concentrate (or dilute) the body’s urine.
Normally the body releases an antidiuretic hormone (ADH) from the pituitary gland into the bloodstream, where it travels to the kidneys. Its job is to concentrate the urine and help the kidneys regulate the amount of water in the body. In children with diabetes insipidus, their bodies may not release enough ADH, and their kidneys may not receive the right amount of ADH. In some children, their kidneys may not respond to the ADH. Without the ability to concentrate urine, a child’s body will release large amounts of diluted urine and the body will become dehydrated.
There are two types of diabetes insipidus:
- Central diabetes insipidus – Happens when not enough ADH is produced or secreted from the pituitary gland. This is the most common type of the disease.
- Nephrogenic diabetes insipidus – Happens when normal levels of ADH are produced and secreted, but the kidneys do not respond to it normally. This is usually due to a genetic problem in the kidneys.
Central diabetes insipidus is caused by damage to the hypothalamus or pituitary gland. This may be due to a head injury, brain surgery, brain tumor, pituitary tumor, encephalitis or meningitis. It may also be due to a genetic disorder.
Nephrogenic diabetes insipidus is the result of a defect in the kidneys, which may be caused by a genetic disorder. It may also be caused by kidney disease, hypercalcemia or taking certain medications, such as lithium.
The symptoms of both types of diabetes insipidus are similar. Symptoms include:
- Drinking large quantities of water without relief of thirst
- Excessive thirst
- Excessive urine production
- Failure to thrive or grow
- Frequent urination
- Frequent nighttime urination
- High fevers
- Poor feeding in infants