Nephrogenic diabetes insipidus

Nephrogenic diabetes insipidus, also called arginine vasopressin resistance, is a form of diabetes insipidus caused by the kidneys failing to respond properly to the hormone vasopressin rather than by a shortage of the hormone itself. In a healthy kidney, vasopressin signals the collecting ducts to reabsorb water and concentrate urine; when the kidney's receptors or downstream signaling do not respond, that reabsorption fails even though vasopressin levels are normal or elevated, so the body loses large volumes of dilute urine. Patients typically present with polyuria, waking at night to urinate, and excessive thirst, and if fluid intake cannot keep pace the result is dehydration, electrolyte imbalance such as high blood sodium, and in severe cases seizures. The condition can be inherited, most often through mutations affecting the vasopressin receptor or the water channel it controls, or acquired later in life from certain medications, high blood calcium, or chronic kidney disease. It is managed across nephrology, endocrinology, urology and medical genetics because both the kidney mechanism and any underlying cause matter to treatment.