Many patients with mild cranial diabetes insipidus (i.e. twenty-four- hour urine volume up to 4 litres) decide to have no therapy, and appear to remain well. These patients rely on their thirst mechanisms to maintain water homeostasis. If an untreated patient is unable to obtain fluid or loses thirst awareness (e.g. is in a coma), the condition can be life-threatening.
Furthermore, long-standing severe cranial diabetes insipidus can lead to hydroureter and hydronephrosis, and possibly to a degree of nephrogenic diabetes insipidus due to solute ΓÇÿwashoutΓÇÖ from the kidney. There are therefore arguments for treating all patients whose urinary output exceeds 4 litres/24h.
See later:
ΓÇó Vasopressin Analogues in Treatment
•ÊNonhormonal Drugs in Cranial Diabetes Insipidus Treatment
