What is Nephrogenic Diabetes Insipidus?
Nephrogenic diabetes insipidus (NDI) is a disorder that occurs when the kidneys cannot concentrate urine correctly. It is a rare kidney disorder affecting the regulation of body fluid levels.
Normally the body balances the fluids you drink with the amount of urine you excrete. However, people with nephrogenic diabetes insipidus produce large amounts of very dilute urine.
When one passes excessive or abnormally large amounts of urine, this is known as polyuria and it causes insatiable thirst or polydipsia.
Nephrogenic diabetes insipidus is unrelated to diabetes mellitus, which is more commonly known as diabetes. Diabetes mellitus causes high blood sugar levels, also known as hyperglycemia. But nephrogenic diabetes insipidus is due to a problem in the kidneys.
Symptoms of Nephrogenic Diabetes Insipidus
The symptoms in infants can include:
- Excessive wet diapers
- Recurring favers that have no known cause
The symptoms in young children can include:
- Difficulties in toilet training
- Mental confusion due to dehydrations
- A failure to thrive
Older children and teenagers can experience symptoms that include:
- Disturbed sleep and fatigue from urinating at night
- High urine output
- A failure to thrive
- Low Body weight due to preferring water to food
The most common symptoms that occur in adults include:
- Frequent urination at night
- Excessive urination
- Excessive thirst
The symptoms of nephrogenic diabetes insipidus can vary from one person to another. In some individuals, these symptoms can become severe and lead to dehydration. Losing excessive amounts of fluid can also cause electrolyte imbalances, which can sometimes be severe.
Symptoms of electrolyte imbalances include:
- Muscle Pains
- Unexplained Weakness
Causes of Nephrogenic Diabetes Insipidus
Normally, the kidneys adjust the concentration and amount of urine according to the body’s needs. Diabetes insipidus occurs when the kidneys are unable to concentrate the urine normally, and a large quantity of dilute urine is released.
During the day, the kidneys filter all the blood many times. Most of the water in the blood is filtered and returned to the blood, and only a small amount of concentrated urine is passed from the body.
The amount of water excreted in the urine is controlled by a hormone called vasopressin or antidiuretic hormone (ADH). Antidiuretic hormone (ADH) is produced in an area of the brain called the hypothalamus. The hypothalamus controls mood and appetite. ADH is then stored in the pituitary gland until needed. The pituitary gland is located below the brain, behind the bridge of the nose.
Nephrogenic diabetes insipidus occurs when the kidneys fail to respond to ADH. Nephrogenic means related to the kidney. ADH normally signals the kidneys to make the urine more concentrated.
Nephrogenic diabetes insipidus involves a defect in the kidneys. Due to the defect, the kidneys release too much water into the urine. As a result, the body produces a large quantity of very dilute urine. When the kidneys don’t concentrate urine correctly, too much water will excrete or expel, from the body.
A variety of factors can affect the body’s regulation of antidiuretic hormone (ADH) and cause nephrogenic diabetes insipidus.
Types of nephrogenic diabetes insipidus (NDI)
Nephrogenic diabetes insipidus can either be acquired or genetic, depending on what’s causing it.
The Acquired form is the more common form of nephrogenic diabetes insipidus and can occur at any time of life. Acquired NDI can occur due to the use of certain medications. Acquired nephrogenic diabetes insipidus can also result from having certain medical conditions. Conditions that can lead to nephrogenic diabetes insipidus include:
- Chronic kidney diseases
- Abnormally high levels of calcium
- Abnormally low levels of potassium
- Sickle cell disease 6 Diabetes inspidius
- Obstruction of the urinary tract
- Rarely during pregnancy
The genetic form is caused by genetic mutations, which are passed down through families. Signs and symptoms of Genetic NDI usually become apparent within the first few months of life. Mutations are mistakes or damage that cause a change or alteration in a person’s genes. These mutations can interfere with the normal functioning of ADH.
Diagnosis of Nephrogenic Diabetes Insipidus
It’s important to get an early diagnosis of nephrogenic diabetes insipidus (NDI) to prevent life-threatening complications. Diagnostic procedures for diabetes insipidus will determine if the kidneys are doing a good job by regulating the amount and concentration of urine.
Urine and blood tests are used to help make a diagnosis. During the test, doctors measure the amount of urine you produce. They may also use a blood test to determine the levels of antidiuretic hormone (ADH) or vasopressin in your blood.
Doctors may also recommend an additional test, known as a water deprivation test. This test is potentially life-threatening and has to be performed by knowledgeable medical teams. During this test, the affected individual is refrained from drinking any liquid for several hours to see if there is a reduction in the volume of urine released.
Doctors may also test your blood and urine for substances such as potassium, calcium, and glucose (blood sugar).
Natural And Home Remedies For Nephrogenic Diabetes Insipidus
There are natural treatments available for nephrogenic diabetes insipidus. The following are some natural home treatments that can address the symptoms of this condition.
Change Your Diet
People with diabetes insipidus will benefit from a diet that contains nutrient-dense whole foods. Also, it can be helpful to consume plenty of water-based, hydrating foods. Some examples of water-heavy foods to consume regularly include watermelon, zucchini, cucumbers, dark leafy green vegetables (such as kale and spinach), citrus fruit, red peppers, red cabbage, blueberries, strawberries, kiwi, and pineapple. Starchy vegetables like bananas, squash, avocados and sweet potatoes are also great options.
Focus on adding these nutrient-dense foods into your diet and try to avoid consuming processed foods. Processed foods contain high amounts of sodium and other chemical preservatives. Avoiding caffeine and carbonated soft drinks may also be helpful.
You’ll need to drink enough liquids to replace your urine losses and to relieve excessive thirst. Drinking extra water will help to compensate for fluid loss, especially after being active or exercising. Inadequate water in the body leads to dehydration and deficits, which can cause muscle cramping, cardiovascular complications, fatigue, confusion, and dizziness.
Plan ahead by carrying water with you wherever you go so that if you’re thirsty while on the go, you’ll have something on-hand right away. It’s important to wear a medical alert bracelet. If you have a medical emergency, health care professionals will recognize immediately your need for fluids.
Keep Your Electrolytes Balanced
Electrolytes are minerals that are present in your body. Calcium, potassium, magnesium, phosphate, chloride, sodium and phosphorus are the major electrolytes within the body. These nutrients help to control nerve and muscle function, balance fluid levels, and your kidneys work hard to keep electrolytes at the right level.
An electrolyte imbalance, which is having too much or too little of an electrolyte, can cause health problems.
You can maintain electrolyte balance in your body by avoiding processed or packaged foods because of their sodium content. A healthy diet provides the electrolytes that your body needs to function properly.
Sodium is an electrolyte that plays a significant role in the body’s ability to retain or release water. A diet that is very high in sodium causes the kidneys to excrete more water. If the kidney excretes too much water, it can cause complications in balancing other electrolytes.
Electrolytes are lost through sweat so it is important to replace them. It’s also important to increase your fluid intake after exercise, during warm weather or any time you are losing fluids. Coconut water is hydrating and can be helpful in balancing your electrolytes.
Keep Your Mouth Moist
Suck on sour candies, ice chips, or sugar-free popsicles to help moisten your mouth and increase the flow of saliva. This helps to reduce your desire to drink later in the evening when you don’t want to consume as much fluid and need to use the bathroom several times throughout the night.
Watch Your Medications
Certain medications may impact an electrolyte imbalance, a complication of diabetes insipidus. Medications that can impact your electrolyte balance include antibiotics, blood pressure medications, hormonal pills, diuretics, and chemotherapy drugs. Cancer patients who are being treated with chemotherapy usually experience serious electrolyte imbalances. Diuretics and laxatives also change sodium and potassium levels within the urine and blood. Electrolyte imbalances can also be caused by hormonal interactions from certain antidiuretic hormone medications.
If you experience the signs and symptoms of nephrogenic diabetes insipidus, you need to find out whether a supplement or medication can be causing electrolyte imbalances.
A major complication of nephrogenic diabetes insipidus is dehydration. To stay hydrated, you need to increase your fluid intake. If you begin to experience the signs and symptoms of dehydration, such as sluggishness, dizziness or confusion, seek medical attention immediately.
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