Difference Between Diabetes Insipidus and SIADH

February 2023 ยท 3 minute read

In SIADH, ADH is not suppressed resulting in water retention and significant electrolyte abnormalities. In DI, there is either decreased production of ADH (central DI), or normal ADH secretion with resistance in the kidneys to its effects (nephrogenic DI). The net result of DI is large volume diuresis of dilute urine.

Is Siadh the same as diabetes insipidus?

Both diabetes insipidus and SIADH have to do with antidiuretic hormone (ADH). With diabetes insipidus, the body has insufficient ADH, and with SIADH, the body has excess (or an inappropriate amount of) ADH.

Is ADH high or low in diabetes insipidus?

ADH is produced in a part of the brain called the hypothalamus. It is then stored and released from the pituitary gland. This is a small gland just below the base of the brain. DI caused by a lack of ADH is called central diabetes insipidus.

How can you tell the difference between normal and Siadh?

The important difference between normal physiology and what occurs in SIADH is the lack of an effective negative feedback mechanism. This results in continual ADH production, independent of serum osmolality.

How does diabetes insipidus cause hyponatremia?

For patients with diabetes insipidus who have hyponatremia, the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and cerebral salt-wasting syndrome should be considered. With SIADH, the unregulated release and subsequent activity of vasopressin leads to hyponatremia caused by excess fluid retention.

Is sodium high or low in DI?

Serum and urine sodium concentrations (SNa, UNa) and osmolarity (SOsm and UOsm) can help distinguish DI, SIADH, and cerebral salt wasting. With DI, SNa and SOsm are high (latter usually > 300) while UOsm is low (usually 50-200).

What causes diabetes insipidus?

Diabetes insipidus is caused by problems with a chemical called vasopressin (AVP), which is also known as antidiuretic hormone (ADH). AVP is produced by the hypothalamus and stored in the pituitary gland until needed. The hypothalamus is an area of the brain that controls mood and appetite.

What are the 4 types of diabetes insipidus?

The types of diabetes insipidus include central, nephrogenic, dipsogenic, and gestational. Each type of diabetes insipidus has a different cause. The main complication of diabetes insipidus is dehydration if fluid loss is greater than liquid intake.

Can diabetes insipidus go away?

There is no cure for diabetes insipidus. But you can work with your doctor to manage the symptoms of this condition. Medicine can help prevent the constant thirst and excessive urination that comes with this condition.

Can diabetes insipidus be cured?

There's no cure for diabetes insipidus. But treatments can relieve your thirst and decrease your urine output.

How do you confirm Siadh?

Diagnosis of SIADH

  • decreased serum osmolality (<275 mOsm/kg)
  • increased urine osmolality (>100 mOsm/kg)
  • euvolaemia.
  • increased urine sodium (>20 mmol/L)
  • no other cause for hyponatraemia (no diuretic use and no suspicion of hypothyroidism, cortisol deficiency, marked hyperproteinaemia, hyperlipidaemia or hyperglycaemia).

    • How do you rule out Siadh?

    Diagnosis of SIADH.

    Therefore, clinicians must rely on surrogate clinical markers of ECV (orthostatic hypotension, skin turgor, mucus membrane dryness, central venous pressure, BUN, BUN-creatinine ratio, and serum uric acid levels), which lack both sensitivity and specificity.

    How serious is Siadh?

    A.

    Symptoms of SIADH are those seen in hyponatremia. Mild hyponatremia can result in occult cognitive slowing and gait abnormalities particularly in the elderly population, along with nonspecific symptoms of headache and nausea. In more severe cases, hyponatremia can lead to seizure, coma and even death.

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