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If there is no change in the water loss despite fluid deprivation, desmopressin may be administered to distinguish between the two types of diabetes insipidus which are central & nephrogenic diabetes insipidus. The time of deprivation may vary from 4 to 18 hours. [2] The serum osmolality and urine osmolality are both measured in the test.
Diabetes insipidus (DI) is a condition characterized by large amounts of dilute urine and increased thirst. [1] The amount of urine produced can be nearly 20 liters per day. [ 1 ] Reduction of fluid has little effect on the concentration of the urine. [ 1 ]
Central diabetes insipidus, recently renamed arginine vasopressin deficiency (AVP-D), [1] is a form of diabetes insipidus that is due to a lack of vasopressin (ADH) production in the brain. Vasopressin acts to increase the volume of blood (intravascularly), and decrease the volume of urine produced.
In neonates, normal urine specific gravity is 1.003. Hypovolemic patients usually have a specific gravity >1.015. Decreased specific gravity (hyposthenuria, i.e. decreased concentration of solutes in urine) may be associated with renal failure , pyelonephritis , diabetes insipidus , acute tubular necrosis , interstitial nephritis , and ...
Central nervous system (CNS) disorders or conditions may cause SIADH in 9% of cases, this includes subarachnoid hemorrhage (56% of CNS causes), pituitary surgery (35% of CNS causes), brain cancer, infections, stroke and head trauma. [2] No cause of inappropriate antidiuresis is initially found in 17–60% of cases. [2]
It is not possible for the kidneys to produce urine with a specific gravity greater than 1.040 [40] but such readings can occur in urine that contains high-molecular weight substances, such as contrast dyes used in radiographic imaging. [38] Specific gravity is commonly measured with urine test strips, but refractometers may also be used. [41]
Both cause excessive urination (hence the similarity in name), but whereas diabetes insipidus is a problem with the production of antidiuretic hormone (neurogenic diabetes insipidus) or the kidneys' response to antidiuretic hormone (nephrogenic diabetes insipidus), diabetes mellitus causes polyuria via osmotic diuresis, due to the high blood ...
The main clinical difference is that of total fluid status of the patient: CSWS leads to a relative or overt low blood volume [3] whereas SIADH is consistent with a normal or high blood volume (due to water reabsorption via the V2 receptor). [1] If blood-sodium levels increase when fluids are restricted, SIADH is more likely. [13]