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    Diabetes Insipidus: Dr.M.Bastanta Tarigan, Sppd-Kemd

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    Angellina Simanjuntak
    This document discusses diabetes insipidus, which causes excessive production of dilute urine. It describes two main types: central diabetes insipidus, caused by a deficiency of the antidiuretic hormone vasopressin; and nephrogenic diabetes insipidus, caused by kidney resistance to vasopressin. The diagnosis involves testing for electrolyte levels and response to water deprivation. Treatment for central diabetes insipidus involves vasopressin supplements, while nephrogenic diabetes insipidus is treated with diuretics or drugs that enhance the effects of vasopressin.

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    Diabetes Insipidus: Dr.M.Bastanta Tarigan, Sppd-Kemd

    Uploaded by

    Angellina Simanjuntak
    56 views8 pages
    This document discusses diabetes insipidus, which causes excessive production of dilute urine. It describes two main types: central diabetes insipidus, caused by a deficiency of the antidiuretic hormone vasopressin; and nephrogenic diabetes insipidus, caused by kidney resistance to vasopressin. The diagnosis involves testing for electrolyte levels and response to water deprivation. Treatment for central diabetes insipidus involves vasopressin supplements, while nephrogenic diabetes insipidus is treated with diuretics or drugs that enhance the effects of vasopressin.

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    Diabetes insipidus

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    This document discusses diabetes insipidus, which causes excessive production of dilute urine. It describes two main types: central diabetes insipidus, caused by a deficiency of the antidiuretic hormone vasopressin; and nephrogenic diabetes insipidus, caused by kidney resistance to vasopressin. The diagnosis involves testing for electrolyte levels and response to water deprivation. Treatment for central diabetes insipidus involves vasopressin supplements, while nephrogenic diabetes insipidus is treated with diuretics or drugs that enhance the effects of vasopressin.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    56 views8 pages

    Diabetes Insipidus: Dr.M.Bastanta Tarigan, Sppd-Kemd

    Uploaded by

    Angellina Simanjuntak
    This document discusses diabetes insipidus, which causes excessive production of dilute urine. It describes two main types: central diabetes insipidus, caused by a deficiency of the antidiuretic hormone vasopressin; and nephrogenic diabetes insipidus, caused by kidney resistance to vasopressin. The diagnosis involves testing for electrolyte levels and response to water deprivation. Treatment for central diabetes insipidus involves vasopressin supplements, while nephrogenic diabetes insipidus is treated with diuretics or drugs that enhance the effects of vasopressin.

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    Diabetes Insipidus

    Dr.M.Bastanta Tarigan,SpPD-KEMD
    Diabetes Insipidus

    • Producer hypotonic polyuria.


    • Central diabetes Insipidus (CDI): Deficient secretion of arginine
    vasopressin (AVP)
    • Primary polydipsia results fron inhibition of AVP release due to excess
    fluid intake.
    • Nephrogenic diabetes Insipidus(NDI): Resistence to the action of this
    hormone.
    Diabetes Insipidus

    Central Diabetes Insipidus Nephrogenic Diabetes Insi


    pidus
    Causa
    Causa Head
    Head trauma.
    trauma. Neoplasma
    Neoplasma pituitary,
    pituitary, granulomatosus
    granulomatosus Resistance to the action od AVP: Herediter is
    disease(
    disease( eg sarcoidosis,histiocytosis X).
    eg sarcoidosis,histiocytosis X). caused by X-Linked transmission of deficient V2
    Mutasi gen.
    Mutasi gen. receptor for AVP and also an autosomal
    Infection
    Infection of
    of the
    the central
    central nervous
    nervous system,
    system, Hypoxic
    Hypoxic dominant defect in the aquaporin-2 gene.
    encephalopathy.
    encephalopathy. Drugs: Lithium, Antibiotic ( democlocycline), anti
    CNS
    CNS vascular
    vascular accidents
    accidents (( Sheehan
    Sheehan syndrome)
    syndrome) fungal, anti neoplastics.
    Idiopathic.
    Idiopathic. Electrolit: persistent hypercalcemia (11 mg/dL) ,
    severe hypokalemia(
    Pathophysiology of diabetes Insipidus
    • AVP is produced in the supraoptic and paraventricular nuclei of the
    hypothalamus. It travels down the pituitary stalk for storages in the
    posterior pituitary.
    • AVP decrease urine flow by increasing reabsorption of solute free water in
    the distal and collecting tubulus od the kidney.
    • APV binds to the tubular V2 receptors, leading to production of cyclic
    adenosin monophosphate,which increase tubular permeability to water by
    perforating the luminal surface with water channels made of aquaporin-2.
    • Hypothalamic osmoreceptors and baroreceptors in the carotids,the atria
    and aorta regulate the secretion of AVP
    Diagnosis of diabetes Insipidus
    Diagnosis of diabetes Insipidus
    Etiology CDI ( Central Diabetes Nephrogenic Diabetes Primary polidipsia
    Insipidus) Insipidus
    Etiology
    Etiology Trauma
    Trauma Family
    Family history
    history History
    History psychiatric
    psychiatric
    Serum
    Serum sodium
    sodium Normal
    Normal or
    or slightly
    slightly elevated
    elevated Normal
    Normal or
    or slightly
    slightly Low
    Low
    elevated
    elevated

    Water Deprvation Oasmolalitas Osmolalitas normal. Osmolalitas


    Water Deprvation
    Testing(WDT) normal Osmolalitas normal.
    Testing(WDT)
    300mOsm normal
    300mOsm
    Treatment of diabetes Insipidus
    Central Diabetes Insipidus (CDI) Nephrogenic Diabetes Insipidus(NDI)

    Desmopressin (DDAVP): adalah modifikasi sintetis AVP. Desmopressin kurang poten karena penyebab NDI
    DDAVP: tersedia dalam bentuk tablet, spray dan nasal adalah resistensi AVP.
    Dosis awal : 1 mg 2x1 Diuretik tiazid menurunkan volume urin . Tiazid
    Ada agent lain yang meningkatkan sekresi AVP yaitu meningkatkan reasorpsi sodium dan air sehingga
    CPZ, Indapamide, Carbamazepine) menurunkan aliran air di tubulus collecting dimana
    tempat tersebut adalah lokasi AVP bekerja.
    NDSAD menurunkan prostaglandin renal sehingga
    meningkatkan kerja AVP dan menurunkan volume urin
    di NDI
    TERIMA KASIH

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