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Diabetes Insipidus - Causes

Causes Of Diabetes Insipidus

Diabetes insipidus occurs when the body cant regulate how it handles fluids.  Normally the kidneys remove excess body fluids from the bloodstream.  This fluid waste is temporarily stored in the bladder as urine.  When the fluid regulation system is working properly, the kidneys make less urine when the body water is decrease, for instance through perspiration, to conserve fluid.
The volume and composition of the body fluids remain balanced through a combination of oral intake and excretion by the kidneys.  The rate of fluid intake is largely governed by thirst, though a persons habits can increase the intake far beyond the necessary amount.  The rate of fluid excreted by the kidneys is greatly influenced by the production of anti-diuretic hormone (ADH), known also as vasopressin.
The body makes ADH in the hypothalamus, and stores the hormone in the pituitary gland, located at the base of the brain.  ADH is released into the bloodstream when necessary.  ADH then concentrates the urine by triggering the kidney tubules to reabsorb water back into the bloodstream rather than excreting as much into the urine.

The way in which the system is disrupted determines which form of diabetes insipidus will develop:

Central diabetes insipidus
The cause of central diabetes insipidus is most often damage to the pituitary gland, or hypothalamus, most often due to surgery, tumor, illness, inflammation or head injury.  In some cases the cause is not known.  This damage disrupts the normal production, storage and release of ADH.

Nephrogenic diabetes insipidus
Nephrogenic diabetes insipidus occurs when there is a defect in the kidneys tubules, the structures in the kidneys which cause water to be excreted or reabsorbed.  This defect makes the kidneys unable to correctly respond to ADH.  The defect could be due to an inherited (genetic) disorder or a chronic kidney disorder.  Certain drugs like lithium and tetracycline can also cause nephrogenic diabetes insipidus.

Gestational diabetes insipidus
Gestational DI occurs only during pregnancy and when an enzyme made by the placenta destroys ADH in the mother.

Dispogenic diabetes insipidus
In this form of diabetes insipidus, known also as primary polydipsia or psychogenic polydipsia, excessive fluid intake leads to suppression of ADH.  Drinking too much liquid can be the result of abnormal thirst caused by damage to the thirst regulating mechanism, situated in the hypothalamus.  Disease like sarcoidosis can cause such damage.  Dispogenic diabetes insipidus can also be caused by mental illness.

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