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Medicine Kidney 9560f3e7

All are true about nephrogenic diabetes insinidu, all except-

A
Increase in urine output
B
Increased sugar in urine
C
No response to ADH
D
No response to vasopressin test
High-Yield Explanation
A decrease of 75% or more in the secretion or action of vasopressin results in diabetes insipidus, a syndrome characterised by production of abnormally large volume of dilute urine. The 24 hr urine volume exceeds 40 ml/kg b. Wt,the osmolarity is <300mosmol/L. It is of majorly of two types -central DI-there is primary deficiency of ADH secretion Nephrogenic DI-there is primary deficiency in the anti diuretic action of vasopressin . How to differentiate between central and nephrogenic DI-measure basal plasma ADH and urine osmolarity under conditions of unrestricted fluid intake. If ADH is normal or elevated(>1pg/ml) and the concurrent urine osmolarity is low(<300mosmol/L)-nephrogenic DI if ADH is low and undectable, nephrogenic DI is very unlikely . vasopressin test:in nephrogenic DI, when analouge of vasopressin -desmopressin is given to patient ,there is no change in the urine osmolarity. It is obsolete now. Ref:Harrison 20 th edition pg no 2685

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