First Things First (assess & treat for the following)
- Water & sodium disorders CANNOT be separated from each other.
- Any statement concerning regulation of water will involve disturbance of sodium concentration & vice versa.
- Regardless of the current sodium concentration, symptomatic fluid deficits (hypovolemia) should be corrected urgently using an isotonic fluid such as lactated Ringer’s or normal saline.
- The cause of DI is lack of ADH (central DI) or lack of ADH effect (nephrogenic DI).
- Virtually any CNS disorder can lead to central or neurogenic DI.
- If pt is taking lithium (or has anytime, especially if recently), then the pt has a component of DI (lithium-induced nephrogenic DI [LINDI]).
- The “classic” findings include polydipsia, polyuria (>30 mL/kg/d), volume depletion & hypernatremia, w/ hyperosmolar serum despite hypo-osmolar urine.
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Last updated: April 26, 2010
"Diabetes Insipidus." Pocket ICU Management, PocketMedicine.com, Inc, 2010. Anesthesia Central, anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534147/all/Diabetes_Insipidus.
Diabetes Insipidus. Pocket ICU Management. PocketMedicine.com, Inc; 2010. https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534147/all/Diabetes_Insipidus. Accessed November 28, 2023.
Diabetes Insipidus. (2010). In Pocket ICU Management. PocketMedicine.com, Inc. https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534147/all/Diabetes_Insipidus
Diabetes Insipidus [Internet]. In: Pocket ICU Management. PocketMedicine.com, Inc; 2010. [cited 2023 November 28]. Available from: https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534147/all/Diabetes_Insipidus.
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