NCBI Bookshelf. Endotext [Internet]. Diabetes insipidus DI is a disorder characterized by excretion of large volumes of hypotonic urine. In most circumstances, DI is also characterized by excessive consumption of water polydipsia.
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The water deprivation test is useful in the workup of patients with polyuria under certain situations. The differential diagnosis of polyuria often comes down to the following: does the patient have diabetes insipidus either central or nephrogenic , psychogenic polydipsia, or an osmotic diuresis e. The first two conditions DI or polydipsia are all characterized by polyuria with a dilute urine osmolarity, but how to distinguish between them?
If the serum sodium is high D. Save my name, email, and website in this browser for the next time I comment. Follow ASNKidney. Read Later Share.
Patients who undergo the water deprivation test should have the urine volume and urine osmolality every hour and plasma sodium concentration eveyr two hours once water deprivation begins. The test is continued until either:. In the situations of either b or c , exogenous ADH is administered and the urine osmolality and volume are further monitored. In central D. Generally individuals with central D. In nephrogenic D. A more detailed protocol for the water deprivation test, approved by the Scientific Advisory Committee of the Diabetes Insipidus Foundation, Inc, can be found here.
And for the really hard-core students of water metabolism, you can check out the following article I stumbled across on PubMed: The use of the water deprivation test for the diagnosis of apparent psychogenic polydipsia in a socially deprived African grey parrot Psittacus erithacus erithacus , published in a issue of Avian Pathology.
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This can be seen in a variety of conditions in the paediatric population, most commonly in patients post neurosurgery or with cerebral malformations. Baseline investigations should include urea and electrolytes, full ward test of urine and paired serum and urine osmolality. The serum sodium is often elevated due to excess free water losses. After assessment of level of dehydration and ongoing losses, adequate rehydration therapy should be commenced. Discussion with the endocrinologist on call is advised prior to the commencement of Desmopressin therapy.
Water deprivation test. While being monitored by a doctor and health care team, you'll be asked to stop drinking fluids for several hours. To prevent dehydration while fluids are restricted, ADH allows your kidneys to decrease the amount of fluid lost in the urine. While fluids are being withheld, your doctor will measure changes in your body weight, urine output, and the concentration of your urine and blood.