What is the prognosis of diabetes insipidus (DI)?

Updated: Mar 18, 2020
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

The prognosis for patients with DI is generally excellent, depending on the underlying illness. In nephrogenic DI caused by medication (eg, lithium), stopping the medication may help to restore normal renal function; after many years of lithium use, however, permanent nephrogenic DI may occur.

DI-related mortality is rare in adults as long as water is available. Severe dehydration, hypernatremia, fever, cardiovascular collapse, and death can ensue in children and elderly people, as well as in persons with complicating illnesses.

A multicenter, retrospective study by D’Alessandri-Silva et al found that among pediatric patients (below age 21 years) with congenital nephrogenic diabetes insipidus (DI), 61% underwent at least one inpatient hospitalization (most commonly due to hypernatremia and failure to thrive), 37% had urologic complications, and, at last follow-up (median age 72.3 mo), 30% of those for whom information was available had chronic kidney disease of stage 2 or above. At the start of treatment, 70% and 71% of patients were below -2 standard deviations for weight and height, respectively, while at last follow-up, these figures had fallen to 29% and 38%, respectively. [26]


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