Diabetes insipidus

Diabetes insipidus (DI) describes the excess production of dilute urine. It is caused by the lack of production or action of the hormone vasopressin (AVP). Diagnosis requires a targeted history and examination. Confirmation requires referral to specialist services with expertise in diagnosis and management. Lack of AVP can be treated with synthetic AVP analogues. Additional approaches can be needed for specific forms of DI. Combined defects in AVP production and thirst perception require a structured programme of fluid intake and antidiuresis. Clinicians should be aware of both systemic and locally progressive pathologies that can present with DI.