Insipidus

Stmctural defects at the receptor level are determinant for a number of receptor diseases. In nephrogenic diabetes insipidus, where patients void large volumes of dilute urine even in the presence of vasopressin (antidiuretic hormone) (105), the disease is linked to mutations in three discrete regions of the G-protein-linked vasopressin (V2) receptor (106,107). 

Deen PM, Marr N, Kamsteeg EJ et al (2000) Nephrogenic diabetes insipidus. Curr Opin Nephrol Hypertens 9 591-595... 

Robben JH, Knoers NV, Deen PM (2006) Cell biological aspects of the vasopressin 1ype-2 receptor and aquaporin 2 water channel in nephrogenic diabetes insipidus. Am J Physiol Renal Physiol 291 F257-F270... 

In central diabetes insipidus a hypophysial malfunction, caused by different diseases as well as head injuries, neurosurgery, or genetic disorders, leads to AVP hyposecretion. This type of diabetes insipidus can successfully be treated by the exogenous administration of AVP or AVP analogues (e.g. desmopressin). 

In nephrogenic diabetes insipidus the kidney s ability to respond to AVP is impaired by different causes, such as drugs (e.g. lithium), chronic disorders (e.g. sickle cell disease, kidney failure) or inherited genetic disorders (X-linked or autosomal NDI). This type of diabetes insipidus can not be treated by exogenous administration of AVP or AVP analogues. Instead, diuretics (hydrochlorothiazide combined or not with amiloride) and NSAI (indomethacin) are administrated to ameliorate polyuria. 

X-linked nephrogenic diabetes insipidus Vasopressin V2 receptor (V2R) SR121463, SR49059... 

Congenital Nephrogenic Diabetes Insipidus (X-llnkedf Autosomal)... 

Congenital nephrogenic diabetes insipidus (NDI) is a rare disease, characterized by an inability to concentrate urine despite normal or elevated AVP plasma... 

AVP is mainly used in the replacement therapy in congenital diabetes insipidus (CDI), but has only a short effect of 4-6 h. It is also used in the therapy of gastrointestinal haemorrhage, as a local vasoconstrictor,... 

Oksche A, Rosenthal W (1998) The molecular basis of nephrogenic diabetes insipidus. JMol Med 76 326-337... 

X-linked nephrogenic diabetes insipidus (NDI) is caused by mutations in the gene for the vasopressin V2 receptor leading to an insensitivity of the kidney for the antidiuretic hormone arginine vasopressin (AVP). The main symptom of the disease is diuresis, i.e., the production of a large amount of diluted urine. Due to the massive loss of water, the patients suffer from thirst and are in danger of dehydration. The disease usually becomes evident shortly after birth. 

Central Diabetes Insipidus Central Tolerance Centrosome... 

X-linked Nephrogenic Diabetes Insipidus X-ray Contrast Agents... 

Diabetes insipidus, hemophilia A, von Willebrand s disease, nodurnal enuresis... 

Diabetes insipidus, prevention and treatment of postoperative abdominal distension, to dispel gas interfering with abdominal x-ray examination... 

Vasopressin and its derivatives are used in die treatment of diabetes insipidus, a disease resulting from die failure of the pituitary to secrete vasopressin or from surgical removal of die pituitary. Diabetes insipidus is characterized by marked increase in urination (as much as 10 L in 24 hours) and excessive tiiirst by inadequate secretion of die antidiuretic hormone or vasopressin. Treatment with vasopressin therapy replaces die hormone in the body and restores normal urination and thirst Vasopressin may also be used for die prevention and treatment of postoperative abdominal distention and to dispel gas interfering with abdominal roentgenography. 

Before administering die first dose of vasopressin for die management of diabetes insipidus, die nurse takes die patient s blood pressure, pulse, and respiratory rate. The nurse weighs the patient to obtain a baseline weight for future comparison. Serum electrolyte levels and odier laboratory tests may be ordered by die primary health care provider. 

D Deficient Fluid Volume related to inadequate fluid intake, need to inotease dose of drug, failure to recognize symptoms of dehydration (diabetes insipidus)... 

Desmopressin may be given orally, intranasally, SC, or IV. The oral dose must be determined for each individual patient and adjusted according to the patient s response to therapy. When the drug is administered nasally, a nasal tube is used for administration. The nasal tube delivery system comes with a flexible calibrated plastic tube called a rhinyle. The solution is drawn into the rhinyle. One end is inserted into the nostril and the patient (if condition allows) blows the other end to deposit solution deep into the nasal cavity. A nasal spray pump may also be used. Most adults require 0.2 mL daily in two divided doses to control diabetes insipidus. The drug may also be administered via the SC route or direct IV injection. 

Wear a medical alert tag identifying the disease (diabetes insipidus) and the drug regimen. 

Signs of a fluid volume deficit are absent (diabetes insipidus). 

Reviews schedule of administration and prescribed number of sprays to each nostril based on signs and symptoms of disease (diabetes insipidus), such as frequency of urination and increased thirst. 

The patient verbalizes an understanding of the treatment modalities and the importance of continued follow-up care (diabetes insipidus). 

Adverse reactions are identified and reported to the primary health care provider (diabetes insipidus). 

The patient verbalizes the importance of complying with the prescribed therapeutic regimen (diabetes insipidus). 

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