What is pituitary diabetes insipidus

Generally, diabetes insipidus is caused by abnormal hormone secretion caused by the pituitary gland. The occurrence of diabetes insipidus also indicates that there is a problem with glomerular reabsorption, which requires timely treatment and observation.

Diabetes insipidus is a syndrome caused by insufficient secretion of antidiuretic hormone (ADH) (central or pituitary diabetes insipidus) or defective renal response to ADH (also known as nephrogenic diabetes insipidus), characterized by polyuria, thirst, low specific gravity urine and hypoosmotic urine. ADH, also known as vasopressin (VP), is mainly synthesized in the supraoptic nucleus and paraventricular nucleus of the hypothalamus. It is a 9-peptide with a molecular weight of 1084. After ADH is secreted, it travels down the thalamus-neurohypophysis bundle to its terminals and is stored in the posterior pituitary gland. Under physiological stimulation, the posterior pituitary gland releases antidiuretic hormone and its transporter protein neurophysin II in a fixed ratio. The secretion of ADH is mainly regulated by plasma osmotic pressure, and is also affected by factors such as effective blood volume, mood, temperature, and drugs.

Oral medication

(1) Hydrochlorothiazide: 25 mg each time, 3 times a day. As a salt diuretic, it can cause mild salt loss. It is possible that on the one hand, reduced blood volume stimulates the secretion and release of ADH, and on the other hand, it increases the reabsorption of water by the proximal tubule, but the exact mechanism is still unclear. It is also effective for nephrogenic diabetes insipidus. When taking the medicine, you should eat a low-salt diet and avoid coffee and cocoa drinks.

(2) Chlorpropamide: In vitro tests can increase the peripheral effects of vasopressin. It may increase the formation of cAMP in the distal convoluted tubule and the release of ADH, but it is ineffective for nephrogenic diabetes insipidus. The dosage is 0.125-0.25g, 1-2 times a day. It will take effect within 24 hours after taking the medicine, and the urine volume will decrease. Side effects include hypoglycemia, leukopenia or liver damage. Combination with hydrochlorothiazide can reduce hypoglycemia reactions.

(3) Clofibrate: The pharmacological action may be to increase the release of ADH. Combination with DDAVP can combat drug resistance. The dosage is 0.2-0.5g/time, 3 times a day. Long-term use may cause side effects such as liver damage, myositis and gastrointestinal reactions.