Diabetes insipidus (DI) is a condition where water in the body is improperly removed from the circulatory system by the kidneys.

There are 2 forms of DI:

  • Central diabetes insipidus (central DI)
  • Nephrogenic diabetes insipidus (NDI)
  • Causes

    Antidiuretic hormone (ADH) controls the amount of water reabsorbed by the kidneys. ADH is made in the hypothalamus of the brain. The pituitary gland, at the base of the brain, stores and releases ADH.

    Central DI occurs when the hypothalamus does not make enough ADH.

    NDI occurs when the kidneys do not respond to ADH.

    Some diabetes insipidus is caused by genetic problems that lead to central DI or NDI. Others may develop after an injury or illness.

    Pituitary Gland

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    Risk Factors

    Factors that may increase your risk of DI include:

  • Damage to the hypothalamus or pituitary glands due to surgery, infection, stroke, brain tumor, or head injury
  • Certain medications, such as lithium—the most common cause of NDI
  • Certain conditions, such as sarcoidosis, tuberculosis, and granulomatosis with polyangiitis
  • Kidney disease such as polycystic kidney disease
  • Protein malnutrition
  • Certain conditions such as hypercalcemia and hypokalemia
  • Symptoms

    Symptoms may include:

  • Increased urination, especially during the night
  • Extreme thirst
  • Dehydration—fast heart rate, dry skin and mouth
  • Diagnosis

    You will be asked about your symptoms and medical history. A physical exam may be done.

    Your bodily fluids may be tested. This can be done with:

  • Blood tests
  • Urine tests
  • Water deprivation test
  • Images may be taken of your bodily structures. This can be done with an MRI scan.


    Talk with your doctor about the best plan for you. Your doctor will work with you to address the underlying cause.

    Treatment may include:

  • For central DI—taking a synthetic form of ADH
  • For NDI—following a low-sodium diet, drinking plenty of water, taking a diuretic
  • Prevention

    There are no known ways to prevent diabetes insipidus. Talk to the doctor right away if you have excessive urination or thirst.