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Causes
By Mayo Clinic staff
Normally, your kidneys remove excess body fluids from your bloodstream. This fluid waste is stored in your bladder as urine. When your fluid regulation system is working properly, your kidneys make less urine when your body water is decreased, such as through perspiration, in order to conserve fluid.
The volume and composition of your body fluids remain balanced through a combination of oral intake and excretion in the kidneys. The rate of fluid intake is largely governed by thirst, although your habits can increase your intake far above the amount necessary. The rate of fluid excreted by your kidneys is greatly influenced by the production of anti-diuretic hormone (ADH), also called vasopressin.
Your body makes ADH in the hypothalamus and stores the hormone in your pituitary gland, a small gland located in the base of your brain. ADH is released into your bloodstream when necessary. ADH then concentrates the urine by triggering the kidney tubules to reabsorb water back into your bloodstream rather than excreting water into your urine.
Diabetes insipidus occurs when this system is disrupted and your body can't regulate how it handles fluids. The way in which your system is disrupted determines which form of diabetes insipidus you have:
- Central diabetes insipidus. The cause of central diabetes insipidus is usually damage to the pituitary gland or hypothalamus, most commonly due to surgery, a tumor, illness (such as meningitis), inflammation or a head injury. In some cases the cause is unknown. This damage disrupts the normal production, storage and release of ADH.
- Nephrogenic diabetes insipidus. Nephrogenic diabetes insipidus occurs when there's a defect in the kidneys tubules — the structures in your kidneys that cause water to be excreted or reabsorbed. This defect makes your kidneys unable to properly respond to ADH. The defect may be due to an inherited (genetic) disorder or a chronic kidney disorder. Certain drugs, such as lithium and tetracycline, also can cause nephrogenic DI.
- Gestational diabetes insipidus. Gestational diabetes insipidus occurs only during pregnancy and when an enzyme made by the placenta — the system of blood vessels and other tissue that allows the exchange of nutrients and waste products between a mother and her baby — destroys ADH in the mother.
In about 30 percent of cases of diabetes insipidus, doctors never determine a cause.
