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July 11, 2002

Diabetes Insipidus

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Question from Dallas, Texas, USA:

My almost three year old son had fetal hydronephrosis, was followed by a pediatric nephrologist until one year of age, and he has always had excessive thirst. He currently drinks approximately 48-60 ounces of fluid per day, including waking up at night twice for juice or water. He usually drinks an eight ounce cup at a time, all at once (what college students refer to as “chugging”). Am I correct in being concerned about diabetes insipidus? If so, what tests should I request from his pediatrician, who is likely to downplay my concerns?

Answer:

From: DTeam Staff

You should ask the doctor to do a urine specific gravity, urine and serum osmolarity, electrolytes and then some determination of vasopressin function. You may need consultation with a pediatric endocrinologist, but the pediatrician (or GP) should be able to get preliminary information. Sometimes thyroid, adrenal, calcium/parathyroid problems also produce similar symptoms as does psychogenic polydipsia.

SB

[Editor’s comment: Diabetes insipidus (DI) is a completely different disorder than diabetes mellitus.

WWQ]