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Diabetes Insipidus, Pediatric

Todd D. Nebesio, MD, FAAP Reviewed 10/2018
 


BASICS

DESCRIPTION

Polyuria and polydipsia caused by the inability to produce or respond to antidiuretic hormone; also called arginine vasopressin 

EPIDEMIOLOGY

Because most cases are secondary to anothe...

DIAGNOSIS

HISTORY

  • Abnormal growth can be a sign of DI.

  • Waking up during the night to drink or void:

    • True DI is associated with polyuria throughout the day and night. Enuresis may be the first sign in a c...

TREATMENT

MEDICATION

  • Desmopressin (DDAVP®): intranasal spray or oral tablets

  • Aqueous vasopressin: SC

    • Comes as 4 mcg/mL solution and doses range from 0.05 mcg up to 1 mcg SC b.i.d. daily. Titrate dose as ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Depends on the patient and underlying disease causing the DI

  • When to expect improvement:

    • Effects of DDAVP® are immediate.

    • Most cases of DI are life...

ADDITIONAL READING

  • Al Nofal A, Lteif A. Thiazide diuretics in the management of young children with central diabetes insipidus. J Pediatr.  2015;167(3):658–661. [View Abstract on OvidInsights]

  • Dab...

CODES

ICD9

  • 253.5 Diabetes insipidus

  • 588.1 Nephrogenic diabetes insipidus

ICD10

  • E23.2 Diabetes insipidus

  • N25.1 Nephrogenic diabetes insipidus

SNOMED

  • 15771004 Diabetes insipidus (disorder)

  • 111395007 Nephrogenic...

FAQ

  • Q: In a patient with an intact thirst mechanism and partial DI, is the use of DDAVP® necessary?

  • A: No, as long as the patient has constant access to free water.

  • Q: How does therapy of DI affect dail...

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