MENA 2024 Recordings-Evaluation and Management of Central DI

Video Transcription

Video Summary

The presentation discusses updates and the management of central diabetes insipidus, now termed arginine vasopressin deficiency (AVPD). It highlights the recent nomenclature changes to reduce confusion with diabetes mellitus, renaming nephrogenic DI to arginine vasopressin resistance (AVPR). The speaker details scenarios to suspect central DI based on symptoms like polyuria and differentiates between solute and water diuresis. AVPD often results from neurohypothesial neuron destruction or vasopressin mutations, whereas AVPR stems from kidney-related issues.<br /><br />Diagnosis relies on urine osmolality and copeptin levels, with copeptin tested under stimulation to distinguish between conditions like AVPD and primary polydipsia. Treatment focuses on desmopressin, diet adjustments, and monitoring to avoid hyponatremia. The challenges of treating postpartum and idiopathic cases, as well as cases involving radiological findings, IgG4-related, and granulomatous diseases, are discussed. Additionally, postoperative considerations and complications such as transient or permanent DI and SIADH are covered, emphasizing a careful balance in sodium levels to prevent complications. The talk concludes by reiterating the importance of individualized treatment and regular monitoring for effective management.

Asset Subtitle

Dr. Adriana Ioachimescu

Keywords

arginine vasopressin deficiency

central diabetes insipidus

diagnosis

desmopressin

nephrogenic diabetes insipidus

polyuria

treatment