ISSN: 1305-385X
Hakkında: Özel sayılar şeklinde yayınlanır.
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Nephrogenic Diabetes Insipidus Diagnosis And Treatment
Dr. Ekrem DOĞANa
aNefroloji BD, Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi, KAHRAMANMARAŞ
Nephrogenic diabetes insipidus (NDI) is characterized by excessive volumes of dilute urine caused by the insensitivity of the distal nephron to the antidiuretic effect of arginine vasopressin. In mild cases, patients are able to compensate for fluid losses with increased water intake. However, in severe cases, uncompensated symptoms can develop, such as marked dehydration, neurological symptoms, and encephalopathy Nephrogenic DI can be hereditary or acquired. In adults, a concentrating defect severe enough to produce polyuria due to nephrogenic DI is most often due to chronic lithium use or hypercalcemia, and less frequently to other conditions that impair tubular function, such as Sjögren's syndrome. Hereditary nephrogenic DI, which is largely an X-linked disease, may also be seen by internists since early recognition and treatment in infancy has led to survival to adulthood. In addition, affected women may be carriers with few or no symptoms until pregnancy or other stres. The urine output in patients with nephrogenic DI can be lowered with a low salt, low protein diet, diuretics, and nonsteroidal antiinflammatory drugs. In infants, early recognition is of immediate clinical significance because treatment can avert the physical and mental retardation that results from repeated episodes of dehydration and hypernatremia.Keywords: Diabetes insipidus, nephrogenic; diabetes insipidusTurkiye Klinikleri J Int Med Sci 2007, 3(21):43-48
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