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November 22, 2009
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Diabetes Insipidus (cont.)

Normal Fluid Regulation in the Body

Your body has a complex system for balancing the volume and composition of body fluids. Your kidneys remove extra body fluids from your bloodstream. This fluid waste is stored in the bladder as urine. If your fluid regulation system is working properly, your kidneys make less urine to conserve fluid when the body is losing water. Your kidneys also make less urine at night when the body's metabolic processes are slower.

Picture of the Hypothalamus

The hypothalamus makes antidiuretic hormone (ADH), which directs the kidneys to make less urine.

In order to keep the volume and composition of body fluids balanced, the rate of fluid intake is governed by thirst, and the rate of excretion is governed by the production of antidiuretic hormone (ADH), also called vasopressin. This hormone is made in the hypothalamus, a small gland located in the base of the brain. ADH is stored in the nearby pituitary gland and released from it into the bloodstream when necessary. When ADH reaches the kidneys, it directs the kidneys to concentrate the urine by returning excess water to the bloodstream and therefore make less urine.

Diabetes insipidus occurs when this precise system for regulating the kidneys' handling of fluids is disrupted. The most common form of clinically serious diabetes insipidus, central diabetes insipidus, results from damage to the pituitary gland, which disrupts the normal storage and release of ADH. Another form, nephrogenic diabetes insipidus, results when the kidneys are unable to respond to ADH. Rarer forms occur because of a defect in the thirst mechanism (dipsogenic diabetes insipidus) or during pregnancy (gestational diabetes insipidus ).

A specialist should determine which form of diabetes insipidus is present before starting any treatment.



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