Management of central diabetes insipidus

Publication date: Available online 31 January 2020Source: Best Practice & Research Clinical Endocrinology & MetabolismAuthor(s): Aoife Garrahy, Christopher J. ThompsonAbstractThe treatment of central diabetes insipidus has not changed significantly in recent decades, dDAVP and replacement of free water deficit remain the cornerstones of treatment. Oral dDAVP has replaced nasal dDAVP as a more reliable mode of treatment for chronic central diabetes insipidus. Hyponatraemia is common, occurring in one in four patients, and should be avoided by allowing a regular break from dDAVP and resultant aquaresis. Hypernatraemia is less common, and typically occurs during hospitalization when access to water is restricted and in cases of adipsic DI. Management of adipsic DI can be challenging, and requires initial inpatient assessment to establish dose of dDAVP, daily fluid prescription, and eunatraemic weight which can guide day-to-day fluid targets in the long-term.
Source: Best Practice and Research Clinical Endocrinology and Metabolism - Category: Endocrinology Source Type: research