Why Do People With Diabetes Insipidus Actually Need A Diuretic Drug?
Hello, I want to ask. The diuretic drug can cause someone to produce more urine than usual, but why do people with diabetes insipidus actually need diuretic drugs?
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To find out indications of drug use, it is first necessary to know about the disease first, and the mechanism of action of the drug. Diabetes insipidus is a disease that causes symptoms of too much urine (polyuria) and consequently being often thirsty and drinking too much (polydipsia). This is caused by one of: (1) a disturbance in the production of antidiuretic hormone (ADH) called diabetes insipidus neurogenic / central (due to interference with the nerves in producing hormones), or (2) impaired kidney response to the hormone, called with nephrogenic diabetes insipidus (due to normal ADH production, but there is a disruption in the kidneys to respond to ADH).
ADH is a type of hormone produced by the pituitary gland, which functions for several things, and one of the most important is to stimulate the kidneys to reabsorb the fluid that will be released by urine. As the name suggests, anti-diuretic means against the process of diuresis (discharge). Therefore, the amount of ADH produced will be adjusted by the brain to regulate fluid requirements, if the body needs fluid, the brain will increase the production of ADH, so that more fluid is retained, so that urine becomes more concentrated (looks more turbid), and vice versa, when the body is mostly fluid, the brain will reduce the production of ADH, which will cause urine to become thinner. In the condition of diabetes insipidus, the body lacks ADH or the kidneys do not respond to ADH, which causes a lack of fluid retention, so that a lot of urine.
However, keep in mind that in addition to water (H20), there is also an electrolyte called Sodium (Na +) which attracts fluids. In the condition of diabetes insipidus, only liquid is released only, without sodium. As a result, body fluids have high sodium concentrations (due to lack of fluids), increase osmolarity, and because the body has a function to restore the condition back to normal osmolarity, this is what stimulates the brain to cause thirst in patients. However, fluid consumption in patients with diabetes insipidus (if sodium is not excreted) will be in vain, because the fluid will be re-excreted through urine.
In the use of diuretic drugs, especially the hydrochorothiazide / HCT group (there are several other types of diuretics), it functions to secrete fluid together with sodium, thereby releasing fluids and also decreasing osmolarity of body fluids together, thus breaking the polydipsi-polyuria chain. Relatively (compared to without treatment), in this case the actual effect of HCT is to reduce urine output.
You can read more details about this process in several sources, such as this link and this link.
Thus, hopefully it can be useful.