Can thiazides treat nephrogenic diabetes insipidus?
Thiazides have been used in patients with nephrogenic diabetes insipidus (NDI) to decrease urine volume, but the mechanism by which it produces the paradoxic antidiuretic effect remains unclear.
What medication treats nephrogenic diabetes insipidus?
Nephrogenic diabetes insipidus. Treatment with the drug hydrochlorothiazide (Microzide) may improve your symptoms. Although hydrochlorothiazide is a type of drug that usually increases urine output (diuretic), it can reduce urine output for some people with nephrogenic diabetes insipidus.
How do thiazide diuretics treat diabetes insipidus?
Thiazide diuretics inhibit the NaCl co-transporter (NCC/TSC) in the renal distal convoluted tubule (DCT) (8). The DCT is water impermeable and considered to be part of the diluting segment (8). Therefore, the water-preserving effect of thiazides is unlikely related to a direct effect on the DCT.
Why do we give diuretics in nephrogenic diabetes insipidus?
Find out more about eating a healthy, balanced diet. If you have more severe nephrogenic diabetes insipidus, you may be prescribed a combination of thiazide diuretics and a non-steroidal anti-inflammatory drug (NSAID) to help reduce the amount of urine your kidneys produce.
How is hydrochlorothiazide used to treat nephrogenic diabetes insipidus though it is diuretic agent?
Hydrochlorothiazide is a thiazide diuretic that decreases urinary volume in the absence of ADH. It may induce mild volume depletion and cause proximal salt and water retention, thereby reducing flow to the ADH-sensitive distal nephron.
How do NSAIDs treat nephrogenic diabetes insipidus?
The antidiuretic effect of NSAIDs in NDI can be explained by the role of prostaglandins in the regulation of renal water excretion. NSAIDs inhibit the enzyme cyclooxygenase and thereby block prostaglandin synthesis in the kidneys.
How thiazide decrease urine output?
The results showed that in the absence of vasopressin, hydrochlorothiazide, when added to the luminal (but not the basolateral) side, increased osmotic and diffusional water permeabilities. Increased permeability facilitates water reabsorption in the terminal nephron segment, thus decreasing urinary volume.
Why thiazides are preferred over furosemide in hypertension?
Thiazide-type diuretics are useful first-line agents in the treatment of hypertension because they have been proven to reduce cardiovascular mortality and morbidity in systolic and diastolic forms of hypertension and do so at low cost.
What are the complications of nephrogenic diabetes insipidus?
If left untreated, severe dehydration may develop. Repeated episodes of severe dehydration may result in significant abnormalities including seizures, brain damage, developmental delays, and physical and mental disability.
How does indomethacin work for nephrogenic DI?
Indomethacin (Indocin) Inhibition of prostaglandin synthesis reduces the delivery of solute to distal tubules, reducing urine volume and increasing urine osmolality. Indomethacin is usually used in nephrogenic DI.
Why thiazides are contraindicated in diabetes?
Prolonged thiazide diuretic therapy can lead to glucose intolerance and may occasionally precipitate diabetes mellitus. Short-term metabolic studies, epidemiologic studies, and a variety of clinical trials suggest a connection between ongoing thiazide diuretic use and the development of type 2 diabetes.
How do thiazide diuretics affect urine output in diabetes insipidus?
I was reviewing the treatment of diabetes insipidus the other day, and was reminded of the paradoxical effect of thiazide diuretics on urine output in diabetes insipidus. How does this work? The traditional thinking is that thiazide-induced blockade of the Na-Cl cotransporter in the distal tubule leads to a decrease in GFR.
How is nephrotic idiopathic diabetes insipidus (NDI) treated?
Treatment consists of adequate free water intake, thiazide diuretics, NSAIDs, and a low-salt, low-protein diet. NDI is characterized by inability to concentrate urine in response to vasopressin.
Which medications are used in the treatment of lithium-induced nephrogenic diabetes insipidus?
Vasopressin, amiloride and thiazide diuretics have been used in lithium-induced nephrogenic diabetes insipidus treatment. Acetazolamide might be an option to treat lithium-induced nephrogenic diabetes insipidus patients who fail to respond to standard treatment.
What is nephrogenic diabetes insipidus (DI)?
INTRODUCTION Nephrogenic diabetes insipidus (nephrogenic DI) results from partial or complete resistance of the kidney to the effects of antidiuretic hormone (ADH).