Radó J
Nephrologia-Hypertonia III. Belgyógyászati Osztály, Fóvárosi Onkormányzat Uzsoki Utcai Kórház Budapest.
Orv Hetil. 1998 Mar 8;139(10):559-63.
The syndrome of polyuria and polydipsia is practically identical in three very different disorders (central diabetes insipidus, nephrogenic diabetes insipidus, primary polydipsia). In congenital nephrogenic diabetes insipidus both the thirst mechanism and the production of the antidiuretic hormone are intact, but the hormone is ineffective in the kidney. The acquired form of the disease is caused most frequently by tubulointerstitial and urinary tract obstructive disorders as well as among the several drugs, lithium. In the differential-diagnosis the results of determinations related to the nomograms of normal interrelationships between osmolality and vasopressin in urine and plasma are used, besides the classical Carter-Robbins and indirect dehydration (Miller) tests. It has been postulated recently that in many cases the resistancy toward vasopressin is not absolute and these partially vasopressin sensitive patients can be treated successfully by thiazide, and potassium sparing compounds, antiprostaglandin pain killers (non-steroid antiinflammatory drugs) and first of all dDAVP as well as combinations of these preparations.
多尿和烦渴综合征在三种截然不同的病症（中枢性尿崩症、肾源性尿崩症、原发性烦渴）中实际上是相同的。在先天性肾源性尿崩症中，口渴机制和抗利尿激素的产生均正常，但该激素在肾脏中无效。该疾病的后天形式最常见的病因是肾小管间质和尿路梗阻性疾病以及多种药物（如锂）。在鉴别诊断中，除了经典的卡特 - 罗宾斯试验和间接脱水（米勒）试验外，还会使用与尿和血浆中渗透压与血管加压素正常相互关系列线图相关的测定结果。最近有人提出，在许多情况下，对血管加压素的抵抗并非绝对，这些对血管加压素部分敏感的患者可以通过噻嗪类药物、保钾化合物、抗前列腺素止痛剂（非甾体抗炎药），首先是去氨加压素以及这些制剂的组合成功治疗。
