Can nephrogenic diabetes insipidus be cured? What are the methods?

The problem of nephrogenic diabetes insipidus mainly occurs in kidney function, so the treatment must be targeted. Nephrogenic diabetes insipidus can actually be cured, but it takes some time, and patients must pay attention to care during treatment.

1. Treatment

The basic principle is to replenish water to maintain water balance and reduce the intake of solutes such as sugar and salt. Pay attention to improving the patient's mental and nutritional status.

1. Provide plenty of fluids to prevent dehydration. For those with acute dehydration, intravenous fluid replacement (using 5% glucose solution) should be given. If the patient's plasma is hyperosmotic, hypotonic fluid infusion should be considered.

2. Limit the intake of solutes, such as giving a low-salt, low-protein diet. Sodium chloride should be controlled at 0.5-1.0 g/d to reduce the need for water.

3. For natriuresis and diuresis, give hydrochlorothiazide (hydrochlorothiazide) 25-50 mg/time, 3 times/day orally, which can reduce urine volume by 50%. Its mechanism may be to stimulate the reabsorption of sodium by the proximal tubule by affecting the production of negative sodium balance in the distal renal tubule, making the fluid flowing through the loop of Medullary and the distal renal tubule hypotonic. Therefore, sodium intake should be limited when using this drug.

4. Indomethacin (Indomethacin), especially when used together with hydrochlorothiazide (Hydrochlorothiazide), can significantly reduce urine volume. The commonly used dosage is 25 mg, 3 times/d. Indomethacin is a nonsteroidal anti-inflammatory drug (NSAIDs). NSAIDs can be used to treat NDI patients with high prostaglandin E syndrome. When patients use NSAIDs, they can prevent the production of prostaglandins and improve clinical symptoms. Clinical studies have found that the combined use of NSAIDs and thiazide diuretics has better therapeutic effect. It can even be used as an emergency medicine. NSAIDs are safer for the treatment of NDI than for other kidney diseases. This may be related to the patient's concurrent high prostaglandin E syndrome. Some studies have found that when hydrochlorothiazide is used for NDI, its effect of reducing urine volume is further enhanced after adding NSAIDs, and it has no significant effect on glomerular filtration rate and renal blood flow. However, the hydrochlorothiazide-indomethacin combination is less well tolerated than hydrochlorothiazide-amiloride therapy. NSAIDs have good therapeutic effects in the treatment of congenital NDI both in utero and outside the uterus. Smith et al. reported that they first used indomethacin to treat polyhydramnios and achieved good results. After the fetus was born and NDI was clearly diagnosed, continued use of indomethacin still had significant therapeutic effects.

5. Symptomatic treatment: if concurrent with hypokalemia or other electrolyte deficiencies, potassium salts or corresponding electrolytes can be supplemented.

6. For secondary cases, the primary disease should be treated according to the cause, and symptomatic treatment can also be given for severe polyuria.