Key Takeaways
- During the day, your kidneys filter all of your blood many times.
- Symptoms of DI include:
- Your health care provider will ask about your medical history and symptoms.
- The cause of the underlying condition will be treated when possible.
- The outcome depends on the underlying disorder.
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Diabetes insipidus (DI) is an uncommon condition in which the kidneys are unable to prevent the excretion of water.
Understanding diabetes insipidus seniors is important for seniors and their caregivers. dI is not the same as
diabetes mellitus types 1 and 2
. However, untreated, both DI and diabetes mellitus cause constant thirst and frequent urination. People with diabetes mellitus have high blood sugar (glucose). Those with DI have normal blood sugar levels, but their kidneys are not able to balance fluid and salt (sodium) in the body.
What Are the Common Causes and Risk Factors?
During the day, your kidneys filter all of your blood many times. Normally, most of the water is reabsorbed, and only a small amount of concentrated urine, relative to the volume of blood, is excreted. DI occurs when your kidneys cannot concentrate the urine normally, and a large amount of dilute urine is excreted.
The amount of water excreted in the urine is regulated by antidiuretic hormone (ADH). ADH is also called vasopressin. ADH is produced in a part of the brain called the hypothalamus. It is then stored and released from the pituitary gland. This is a small gland just below the base of the brain.
DI caused by a lack of ADH is called
central diabetes insipidus
. When DI is caused by a failure of the kidneys to respond to ADH, the condition is called
nephrogenic diabetes insipidus
. Nephrogenic means related to the kidney.
Central DI is uncommon. It can be caused by damage to the hypothalamus or pituitary gland as a result of:
- Genetic problems
- Head injury (common cause)
- Infection in the brain
-
Problem with the ADH-producing cells due to an
autoimmune disease
- Loss of blood supply to the pituitary gland
- Surgery in the area of the pituitary gland or hypothalamus (most common cause)
-
Tumors
in or near the pituitary gland
Nephrogenic DI involves a defect in the kidneys. As a result, the kidneys do not respond to ADH. Nephrogenic DI is uncommon. Nephrogenic DI may be caused by:
- Certain medicines, such as lithium
- Genetic problems
-
High level of calcium in the body (
hypercalcemia
)
-
Kidney disease, such as
polycystic kidney disease
What Are the Symptoms and Warning Signs?
Symptoms of DI include:
-
Excessive thirst
that may be intense or uncontrollable, usually with the need to drink large amounts of water or craving for ice water
-
Excessive urine volume
- Excessive urination, often needing to urinate every hour throughout the day and night
- Very dilute, pale urine
📖 What Are Exams and Tests?
What Are Exams and Tests?
Your health care provider will ask about your medical history and symptoms.
Tests that may be ordered include:
-
Blood sodium
and
osmolality
- Desmopressin (DDAVP) challenge
-
MRI of the head
- Serum co-peptin level
-
Urinalysis
-
Urine concentration
and
osmolality
- Urine output
Your provider may have you see a pituitary diseases specialist (endocrinologist) to help diagnose DI.
📖 How Is It Treated?
How Is It Treated?
The cause of the underlying condition will be treated when possible.
Central DI may be regulated with desmopressin (also called DDAVP which has actions in the body like vasopressin). You may take desmopressin as an injection, a nasal spray, or tablets.
If nephrogenic DI is caused by a medicine, stopping the medicine may help restore normal kidney function. But after many years of use of some medicines, such as lithium, nephrogenic DI can be permanent.
Hereditary nephrogenic DI and lithium-induced nephrogenic DI are treated by drinking enough fluids to match urine output. Medicines that lower urine output also need to be taken.
Nephrogenic DI is treated with anti-inflammatory medicines and diuretics (water pills).
📖 What Is Outlook (Prognosis)?
What Is Outlook (Prognosis)?
The outcome depends on the underlying disorder. If treated, DI does not cause severe problems or result in early death.
📖 What Are Possible Complications?
What Are Possible Complications?
If your body’s thirst control is normal and you are able to drink enough fluids, there are no significant effects on body fluid or salt balance.
Not drinking enough fluids can lead to
dehydration
and
electrolyte
imbalance, which can be very dangerous.
If DI is treated with vasopressin and your body’s thirst control is not normal, drinking more fluids than your body needs can also cause a dangerous electrolyte imbalance.
📖 When to Contact a Medical Professional?
When to Contact a Medical Professional?
Contact your provider if you develop symptoms of DI.
If you have DI, contact your provider if frequent urination or extreme thirst returns after treatment.
-
Endocrine glands
-
Osmolality test
Christ-Crain M, Thompson CJ, Verbalis JG. Posterior pituitary. In: Melmed S, Auchus RJ, Goldfine AB, Rosen CJ, Kopp PA, eds.
Williams Textbook of Endocrinology
. 15th ed. Philadelphia, PA: Elsevier; 2025:chap 8.
Soto-Rivera CL, Breault DT, Majzuob JA. Diabetes insipidus. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds.
Nelson Textbook of Pediatrics
. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 596.
Verbalis JG. Disorders of water balance. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds.
Brenner and Rector’s The Kidney
. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 15.
Verbalis JG. Posterior pituitary. In: Goldman L, Cooney KA, eds.
Goldman-Cecil Medicine
. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 206.
Updated by: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
-
Diabetes Insipidus
Frequently Asked Questions
Key Takeaways
Your health care provider will ask about your medical history and symptoms. The cause of the underlying condition will be treated when possible.
What Are the Common Causes and Risk Factors?
What Are the Symptoms and Warning Signs?
Excessive thirst
that may be intense or uncontrollable, usually with the need to drink large amounts of water or craving for ice water
Excessive urine volume
Excessive urination, often needing to urinate every hour throughout the day and night
Very dilute, pale urine
📖 What Are Exams and Tests?
What Are Exams and Tests?
Blood sodium
and
osmolality
Desmopressin (DDAVP) challenge
MRI of the head
Serum co-peptin level
Urinalysis
Urine concentration
and
osmolality
Urine output
Your provider may have you see a pituitary diseases specialist (endocrinologist) to help diagnose DI. 📖 How Is It Treated?
How Is It Treated?
About the Author: This article was researched and written by the SilverWell Hub editorial team. It was medically reviewed by Dr. Sarah Mitchell, MD, Geriatrics.
Sources: This article is adapted from MedlinePlus, a service of the National Library of Medicine.
Disclaimer: This information is for educational purposes only. See our full Medical Disclaimer.
Published: July 21, 2026 | Next review: January 2027
