Discussions By Condition: I cannot get a diagnosis.

Chronic Thirst and Urination

Posted In: I cannot get a diagnosis. 1 Replies
  • Posted By: Anonymous
  • July 20, 2009
  • 02:41 AM

I am posting this question about a diagnosis for my sister. Recently, probably a few months back, she starting developing very frequent thirst and urination. At first, we thought it could be due to UTI but as the symptoms did not get better she went to get it checked out. They ran both urine and blood tests, with no significant findings as we thought it could be early precursors of diabetes. Since she has no health insurance most of these tests have been done at a free clinic, but there nephrologist focuses more on renal failure. She can't really get a clear answer for this problem. One of her blood tests did show that she was dehydrated even though she drinks water excessively. Her thirst is pretty excessive, she drinks about 10-15 water bottles a day. Sometimes she feels near fainting or nausea if she doesn't have something to drink with her. I should also add that she is taking methadone, because she is a recovering IV drug user. I was trying to do some research to see if her drug use might have something to do with this problem, but didn't get very far because it was very vague information about kidney failure. The doctor she had been seeing suggested seeing and endocrinologist, but since she has no health insurance this causes a problem. The doctor also said that it could be diabetes insipidus but that he didn't think so because it is so rare and usually genetic. If anyone could help it would be greatly appreciated!

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  • Heroin use can lead to amyloidosis which may affect the kidney. Amyloidosis of the kidney can result in various kidney problems including glomerulonephroitis, renal tubular acidosis and nephrogenic diabetes insipidus. What happens in nephrogenic diabetes insipidus is that an abnormal protein (amyloid) can deposit in the kidney tubules. The kidney tubules may then become unresponsive to a hormone called ADH (antidiuretic hormone) which is required by the kidneys to reabsorb water from the urine, making it more concentrated. Diabetes insipidus (DI) needs to be differentiated from psychogenic polydipsia (where a person just basically drinks a lot of water without any underlying physical abnormality). Testing involves measurements of serum osmolality and the water deprivation test. (You can think of osmolality as the concentration of substances such as sodium, potassium etc in the body fluids.) Serum osmolality tends to be high in nephrogenic DI, but low in psychogenic polydipsia. In simple terms, the water deprivation test is conducted by depriving the individual of water and then measuring urine osmolality after some time. Later antidiuretic hormone (ADH) is administered. In nephrogenic DI, there will be no increase in urine osmolality with either water deprivation or with ADH.
    m3dh31p 69 Replies Flag this Response
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