Renal non-sugar diabetes

Nephrogenic diabetes insipidus involves polyuria, polydipsia, and the inability of the kidneys to concentrate urine.

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Causes renal non-sugar diabetes.

Renal diabetes insipidus develops due to the presence of a lack of sensitivity of epithelial cells of the distal tubules to arginine vasopressin (antidiuretic hormone), which is mainly due to a mutation of the V1-receptor gene of arginine vasopressin (X-linked form). In addition, the cause is a mutation of the gene encoding the water channel associated with the V2-receptor - aquaporin-2 (autosomal recessive form of inheritance).

Acquired renal diabetes insipidus develops with many diseases.

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Symptoms renal non-sugar diabetes.

Primary renal diabetes insipidus is diagnosed in the first week of life.

Symptoms are typical: polyuria, repeated vomiting, convulsions; severe dehydration andhyponatremia often develop.

In older children, polyuria, nocturia, and polydipsia are detected.

Forms

Congenital renal diabetes insipidus

• Mutations in the genes of V1 receptors of antidiuretic hormone.
• Mutation of the aquaporin-2 gene.

Acquired renal diabetes insipidus

• Medicines:
  • lithium preparations;
  • amphotericin B.
• Nicotine.
• Alcohol.
• Chronic renal failure (especially as a result of tubulointerstitial nephritis and obstructive uropathy).
• Sickle cell anemia.
• Amyloidosis.
• Sjogren's disease and syndrome.
• Sarcoidosis.
• Hypercalcemia.
• Cystinosis.

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Diagnostics renal non-sugar diabetes.

Increased concentrations of sodium, chlorides, and urea are characteristic. Hyposthenuria is typical: the relative density of urine does not exceed 1005.

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Differential diagnosis

Diagnosis is made using a vasopressin test. In renal diabetes insipidus, its administration, unlike the pituitary form of the disease, does not cause an increase in the relative density of urine and a decrease in its volume.

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Treatment renal non-sugar diabetes.

Treatment involves the administration of hydrochlorothiazide, potassium supplements, and drinking plenty of fluids.

Limited sodium intake is also justified. Secondary renal diabetes insipidus can be completely eliminated by treating the underlying disease.