What is diabetes insipidus (DI)?

Diabetes insipidus (DI) is a condition in which the kidneys cannot regulate the amount of fluid in the body. This causes the body to make too much urine, which can cause dehydration.

There are 2 types of diabetes insipidus. Each type of DI is treated by a different type of doctor.

  • Central or neurogenic DI is when the pituitary gland (a small gland just below the brain that controls other glands in the body) doesn’t release vasopressin into the bloodstream. Children with central or neurogenic DI are treated by endocrinologists (endocrine gland doctors).
  • Nephrogenic DI is when the kidneys don’t respond to vasopressin. Children with nephrogenic DI are treated by nephrologists (kidney doctors).

What is Vasopressin?

Vasopressin is a hormone that helps keep the right amount of water in the body. It is often called antidiuretic hormone or ADH.

Vasopressin is made by the hypothalamus (a small part of the brain just above the pituitary gland) and stored in the pituitary gland for the body to use. The back part of the pituitary gland stores the vasopressin until the body needs it.

Normally, when the body needs to hold onto fluid, the pituitary gland releases vasopressin to the kidneys. This makes the kidneys retain fluid so the body doesn’t become dehydrated. This causes the kidneys to make less urine than usual.

When there is a problem with vasopressin, the kidneys lose too much fluid. This causes dehydration and frequent urination.

What causes diabetes insipidus?

The causes of central or neurogenic DI and nephrogenic DI are different.

Central or neurogenic DI

  • Damage to the hypothalamus or pituitary gland
  • Head trauma
  • An infection, tumor or growth near the hypothalamus or pituitary gland
  • Surgery near the hypothalamus or pituitary gland
  • Poor development of the hypothalamus or pituitary gland before birth
  • Randomly and for no explained reason. We call this idiopathic DI, which means we don’t know the cause or reason of the central or neurogenic DI.

Nephrogenic DI

  • Genetic problems in which the kidney doesn’t properly respond to vasopressin or other parts of the kidney’s water-saving machinery
  • Medications, such as lithium and demeclocycline (an antibiotic)
  • Urinary tract infections (UTI)
  • Imbalance of certain blood chemicals, like calcium and potassium
  • Damage to the kidney tubules (tubes inside the kidneys that transfer water and salt into urine)

What are the symptoms of diabetes insipidus (DI)?

Children with DI might show these symptoms:

  • Extreme thirst. If your child doesn’t have enough to drink, he/she might find fluids from unusual places, like a garden hose, bathtub or fish tank.
  • Needing to urinate more often than usual, especially at night. Some children might wet the bed at night.
  • Preferring ice cold water to other liquids
  • Weight loss in children. Children might lose weight because they are too busy drinking water and urinating and not eating enough food.
  • Weight gain in babies. Babies might gain weight from drinking too much milk in order to get enough fluid.
  • Dehydration
Rev. 9/2015. Mass General for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.