The kidneys filter water and waste products from the blood. Before urine passes to the bladder, the kidneys reabsorb much of the water initially filtered. This action conserves body water and concentrates the urine. The kidneys of people with nephrogenic diabetes insipidus cannot concentrate urine, resulting in ongoing water loss. Nephrogenic diabetes insipidus--which is not related to diabetes mellitus or blood sugar levels--can be inherited or develop during life. Treatment for nephrogenic diabetes insipidus focuses on maintaining adequate water in the body.
Hydration
Among patients with nephrogenic diabetes insipidus, the inability to concentrate the urine can easily lead to dehydration. Significant dehydration commonly causes low blood pressure, dizziness, dry mouth and dry skin. Drinking sufficient water to replace urinary losses remains an essential component of treatment for nephrogenic diabetes insipidus, reports the National Library of Medicine encyclopedia MedlinePlus. The daily intake of water should approximately match the amount of urine produced daily. Additional water intake proves necessary during periods of increased sweating or when a fever, diarrhea or vomiting occur. Doctors provide guidelines for their patients on the amount of water needed to ensure adequate hydration.
Salt Restriction
Salt intake may increase urine output as the body tries to rid itself of excess sodium. A low-salt diet, therefore, may help reduce the volume of urine output in people with nephrogenic diabetes insipidus, note Drs. Stephen Ball and Peter Bayliss on the endocrinology information website Endotext.org. In addition to reducing the use of table salt, patients need to be aware of salt content in canned goods, condiments, luncheon meats, snacks and other processed foods.
Low-Protein Diet
A high-protein diet can increase urinary volume by augmenting the amount of protein breakdown products to be excreted by the kidneys. Doctors often recommend a low-protein diet for patients with nephrogenic diabetes to help conserve body water, reports the Merck Manual for Healthcare Professionals.
Hydrochlorothiazide
The diuretic hydrocholorothiazide may prove useful in decreasing urine output in patients with nephrogenic diabetes insipidus, reports Dr. Robert Wildin of Oregon Health Sciences University on the website of the Diabetes Insipidus Foundation. Diuretics normally increase urine output. Among patients with nephrogenic diabetes insipidus, however, hydrochlorothiazide usually has the opposite effect.
Nonsteroidal Anti-inflammatory Drugs
Nonsteroidal anti-inflammatory drugs, or NSAIDs, may help reduce urinary water loss among patients with nephrogenic diabetes insipidus, note Drs. Ball and Bayliss. Commonly prescribed NSAIDs for nephrogenic diabetes insipidus include ibuprofen and indomethacin.
Medication Adjustments
Certain prescription medications can lead to nephrogenic diabetes insipidus. Drugs associated with this condition include lithium, aminoglycoside antibiotics, the cancer drugs cisplatin and ifosfamide, and the weight loss drug orlistat, notes the Merck Manual for Healthcare Professionals. Doctors may adjust dosages or change to another medication, if possible, to potentially alleviate symptoms of nephrogenic diabetes insipidus.
References
- MedlinePlus: Diabetes Insipidus-Nephrogenic
- Endotext.org: Normal and Abnormal Physiology of the Hypothalamus-Posterior Pituitary (Including DI and SIADH)
- The Merck Manual for Healthcare Professionals: Nephrogenic Diabetes Insipidus
- The Diabetes Insipidus Foundation: What is NDI?
- Gene Reviews: Nephrogenic Diabetes Insipidus
