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Aetiology

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Nephrogenic diabetes insipidus is most commonly due to osmotic diuresis. Familial disease causes profound polyuria but is uncommon; it is sex linked recessive and thus more severe in boys

Acquired causes include:

  • osmotic:
    • diabetes mellitus
    • mannitol
    • post obstructive uropathy

  • chronic renal disease:
    • interstitial nephritis
    • polycystic kidneys
    • sickle cell anaemia
    • sarcoid
    • amyloid

  • metabolic:
    • hypercalcaemia
    • hypokalaemia

  • drugs:
    • lithium
    • demeclocycline
    • vitamin D
    • methoxyfluorane

  • solute washout from medulla due to prolonged polyuria of any cause

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