Do you often feel unbearably thirsty? And do you often urinate a lot? Although this may seem normal, sometimes there may be an unknown medical condition behind it. Today we are going to talk about such a rare but very important medical condition to be aware of.
What exactly is Nephrogenic Diabetes Insipidus?
When you hear this name, you might think that this is something like Diabetes Mellitus, which we all know. But this is not sugar-related diabetes . As we know, diabetes is caused by high blood sugar levels. But nephrogenic diabetes insipidus is a problem entirely related to the kidneys .
Simply put, there is a special hormone released by the brain to control the amount of water in our bodies. This is called the antidiuretic hormone, or ``Antidiuretic Hormone - ADH''. When you are dehydrated, or dehydrated, this ``ADH'' hormone is released from the brain and sends a signal to the kidneys, saying, "Okay, now hold on to the water in your body and reduce the amount of urine you produce."
However, in a person with nephrogenic diabetes insipidus, even though the brain produces enough ADH, the kidneys cannot recognize that signal. It's like you can't hear someone talking to you. Because the ADH sensors in the kidneys don't work properly, the kidneys are unable to absorb and retain water in the body. As a result, a large amount of the water the body needs is excreted in the urine.
So why is this called "Insipidus"? "Insipid" means tasteless, dull. In the past, doctors used to taste urine to diagnose diseases. In diabetes, the urine tastes sweet (that's why it's called "mellitus," which means sweet). But in this disease, the urine is dull, like water. That's why it's called "Insipidus."
What are the main symptoms of this disease?
These are the main symptoms of kidney failure. For some people, these symptoms can be so severe that they are unbearable.
| Symptom | Description |
|---|---|
| There is a strong thirst for water. | A feeling of unbearable thirst that never goes away. |
| Excessive urination (Polyuria) | Frequent, large amounts of clear , watery urine throughout the day. |
| Dehydration | Excessive fluid loss from the body causes symptoms such as dry skin, dry mouth, and headaches. |
| Electrolyte Imbalance | Excessive fluid loss can cause changes in the amount of salts in the blood, such as sodium and potassium. This can cause the following symptoms:
|
Imagine, some people need to drink a big glass of water every 15 minutes. All day, every day. So because that water doesn't stay in the body, they have to go to the bathroom every so often. You can imagine how much of a disruption this is to life, right?
What causes this situation?
There are several causes of nephrogenic diabetes insipidus.
In young children and infants
This condition is often caused by a genetic defect in babies. This means that the part of the kidneys that responds to the ADH hormone (receptor) does not function properly.
In adults
This condition in adults is not caused by genetic factors. It is influenced by other factors.
- Some medications: Especially the drug `Lithium`. This is a drug given to treat mental illnesses such as bipolar. About 20% of people taking `Lithium` can develop this condition. Also, other drugs such as `Demeclocycline` and `Ofloxacin` can cause it.
- Changes in saliva levels:
- High blood calcium levels (Hypercalcemia).
- Low potassium levels in the blood (Hypokalemia).
- Kidney disease: Especially chronic kidney diseases such as polycystic kidney disease.
There is also another type of "diabetes insipidus". It is called central diabetes insipidus. What happens in this case is that the kidneys work well, but the brain does not produce enough ADH hormone . It is not a problem with the kidneys, but a problem with the brain.
How is it treated?
To be honest, treating nephrogenic diabetes insipidus is a bit challenging. Because the kidneys don't respond to the hormone `ADH`, giving `ADH` externally won't help. However, there are ways to control the symptoms.
1. Treating the cause: If your doctor determines that the condition is caused by a medication you are taking, such as lithium, the medication may be changed or stopped.
2. Lifestyle changes:
- Drink water regularly: This is the most important thing . You need to drink water regularly to replenish the amount of water lost from the body. It is essential to prevent dehydration.
- Diet: Eating a diet low in salt and protein can help reduce the amount of urine you pass. Talk to your doctor about this and get advice.
3. Medicines:
- NSAIDs: Painkillers like ibuprofen can help reduce urination somewhat. However, you should consult your doctor before using these for long-term use.
- Diuretics: This may come as a surprise to you. These so-called "water pills" are usually given to help the body eliminate water. But surprisingly, a diuretic like `Hydrochlorothiazide` can help reduce urine output in this condition. Its mechanism of action is a bit complicated, so it should be used exactly as prescribed by your doctor.
Very important: People with this condition need to urinate frequently. Holding in until the bladder is full can cause long-term damage. So urinate as soon as you feel the need.
If you have these symptoms, don't panic, but definitely see a doctor for advice. It is very important to get the necessary tests done and determine exactly what condition you have.
Take-Home Message
- Nephrogenic diabetes insipidus is not diabetes, but a condition caused by the kidneys' inability to respond to a hormone .
- The main symptoms are unbearable thirst and excessive urination .
- The most important treatment for this is to drink plenty of water and avoid dehydration.
- Some medications, changes in blood salt levels, and other kidney diseases can cause this.
- If you have these symptoms, don't guess and see a doctor immediately for a proper diagnosis and treatment .
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