Diagnosis and treatment of central diabetes insipidus

Abstract

Diabetes insipidus represents a serious disease that dramatically interferes with the everyday life of patients due to the need to constantly replenish of fluid lost in the urine, which comes amid shortage of synthesis, secretion or action of pituitary hormone vasopressin. The main difficulty is the differential diagnosis of types of diabetes insipidus in patients with the syndrome of polydipsia-polyuria as the correct differential diagnosis of these forms predetermine the safety and efficacy of further treatment. This lecture presents the current concepts of etiology, diagnosis and treatment of central diabetes insipidus (CDI). We give the comparative characteristics of various preparations of desmopressin for the treatment of the central form of the disease. We also consider the features of the management of selected patient populations with CDI: during pregnancy and lactation, pathology of the thirst sensation, after traumatic brain injury and neurosurgery.