Nephrogenic+diabetes+Insipidus+(Christopher+McMullen)



Nephrogenic diabetes insipidus is a form of diabetes where there is an issue with the reception of antidiuretic hormone (ADH), also know as vasopressin, to receptors on the collecting duct within the kidneys. ADH is responsible for allowing the human body to retain water and is usually expressed in situations of high activity of exercise. ADH is usually inhibited when humans usually drink coffee or alcohol, resulting in frequent urination. This is one of the key symptoms of nephrogenic diabetes insipidus. Because receptors within the collecting duct of the kidneys are no longer responding to ADH, water is not being reabsorbed and is passing directly in to the bladder. This causes complications such as extreme dehydration, loss of electrolytes, fatigue, and irritability. People with Nephrogenic diabetes insipidus can urinate up 2-3 liters per hour, they usually need to be near bathroom and have to constantly keep hydrated.


 * 1) Name: Nephrogenic diabetes insipidus
 * 2) Root cause: Reception of antidiuretic hormone (ADH), also know as vasopressin in kidneys
 * 3) Affected cell types/tissues/organs/systems: V2 receptor and aquaporins P2 water channel in collecting duct of kidneys.
 * 4) Historical Background: Nephrogenic diabetes insipidus is very rare. Most people have not heard about this form of diabetes. The only similar symptom it shares with the popular diabetes mellitus is frequent urination. Discoverer is not known.
 * 5) Symptoms: Excessive thirst, excessive urination, unexplained weakness, lethargy, muscle pains, irritability.
 * 6) Treatment: Extremely low sodium diet, taking a thiazid diuretic pill, staying hydrated.
 * 7) Current Research: In vitro studies show that most mutations in //AVPR2// result in V2 receptors that are trapped intracellularly and are unable to reach the plasma membrane (19, 20). A few mutated V2 receptors reach the cell surface, but they can not bind vasopressin or properly trigger an increase in intracellular cyclic AMP (14). Of interest, nonpeptide V2 receptor antagonists were recently found to increase urine osmolality and to facilitate the folding of mutant V2 receptors in patients with several different mutations in the //AVPR2// gene (21). This finding is very important because it suggests that it may be possible to find pharmacologic agents that will enable mutant but partially functional V2 receptors to move to the membrane and restore partial vasopressin responsiveness and water reabsorption capability to the collecting duct.1
 * 8) References:


 * 1) 1. Sands. J. M., Bichet, D.G. Nephrogenic Diabetes Insipidus. Physiology in Medicine: a Series of Articles Linking Medicine with Science. Annals Of Internal Medicine. V144. #3. 2006 Feb.7.


 * 1) 2. Sect. 7, Ch. 8: Nephrogenic Diabetes Insipidus." Sect. 7, Ch. 8: Nephrogenic Diabetes Insipidus. N.p., n.d. Web. 01 Oct. 2014.


 * 1) 3. "Nephrogenic Diabetes Insipidus: Treatments and More." WebMD. WebMD, n.d. Web. 01 Oct. 2014.


 * 1) 4. "Diabetes Insipidus vs. Diabetes Mellitus." Diabetes Insipidus vs Diabetes Mellitus. N.p., n.d. Web. 01 Oct. 2014. Web. http://www.the-aps.org/mm/Publications/Journals/PIM/sands-pdf.pdf