Mainstay of treatment of Nephrogenic Diabetes Insipidus is:
Correct Answer: Thiazide / Amiloride diuretics and salt restriction
Description: Answer is B (Thiazide / Amiloride diuretics and salt restriction): The treatment of Nephrogenic Diabetes Insipidus is usually achieved through a combination of thiazide / amiloride diureties and dietary salt restriction. A prostaglandin synthesis inhibitor (indomethacin) may be added. Thiazide diuretics and salt restriction can reduce urinary output by inducing a state of mild volume contraction thereby promoting increased proximal reabsorption of isotonic fluid and inhibiting the delivery of free water to the collecting duct. A combination of thiazide - amiloride formulation will avoid thiazide induced hypokalemia. Addition of Indomethacin may fuher reduce urinary output by inhibiting prostaglanding synthesis-Harrison Thiazide diuretics in combination with amiloride and indomethacin are the most useful pharmacological agents in the treatment of Nephrogenic diabetes insipidus'- Pediatric Endocrinology (CDC Press) 2007/668 Desmopressin is usually ineffective in Congenital Nephrogenic Diabetes Insipidus. If renal resistance is paial, it may be overcome by ten fold higher doses of desmopressin but this treatment is too expensive and inconvenient to be useful chronically.
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