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DR Medhat MRCP

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Treatment of DI :<br />

Cranial DI (ie with normal<br />

kidney response<br />

Nephrogenic DI<br />

ADH analogues<br />

Fluid replacement<br />

Drugs that kidney<br />

sensitivity to ADH<br />

Desmopressin (DDAVP)<br />

One of the following<br />

1. Thiazide/amiloride diuretics<br />

- [drug of choice] 2. High dose DDAVP (in partial<br />

- Use lowest dose ( once weekly) nephrogenic DI).<br />

3. NSAIDS<br />

4. Carbamazipine<br />

5. Dietary salt restriction<br />

Dipsogenic DI<br />

- Reduction of fluid intake is the only rationale treatment.<br />

Prognosis of DI :<br />

- Depends on the underlying disorder.<br />

Syndrome of inappropriate secretion of ADH (SIADH)<br />

( واضح من اسمه : زيادة = water intoxication )ADH<br />

Causes :<br />

1) Malignancy (ADH secreting tumours) :<br />

- Especially small cell lung cancer.<br />

- Pancreatic , prostatic cancers.<br />

2) Infections :<br />

- TB<br />

- Pneumonia.

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