RISK FACTORS: RISK FACTORS:

 Head trauma  Failure of the renal tubules to respond to ADH

 Brain tumor  Genetic, X-linked recessive trait of nephrogenic diabetes insipidus
 Surgical ablation or irradiation of pituitary gland  Kidney disease
 Infection of the CNS or tumors  Hypokalemia and hypercalcemia

Posterior pituitary gland dysfunction Hypothalamus dysfunction Kidney dysfunction

paraventricular and supraoptic nuclei stimulation

↓ stimulation of the posterior pituitary gland

↓ release of ADH

↓ ADH plasma levels ↓ water reabsorption into the blood from the urine filtrate ↑ volume of diluted urine

↑ plasma (serum) osmolality  Severe dehydration

 Weight loss
↓ arterial BP (hypotension) Stimulation of the thirst center of the hypothalamus  Specific gravity
becomes 1.001 to
1.005
Tachycardia ↑ sympathethic discharge Polydipsia (great thirst)  ↓ urine osmolality

↓ renal perfusion

renin

↑ angiotensin I and II

↑ aldosterone

↓ Na+ excretion Hypernatremia

Pathophysiology of Diabetes Insipidus