**Core Concept**
Nephrogenic diabetes insipidus (NDI) is a condition characterized by the kidneys' inability to concentrate urine in response to antidiuretic hormone (ADH). This results in excessive urine production and polyuria.

**Why the Correct Answer is Right**
The primary cause of NDI is the resistance of the renal collecting ducts to ADH, which is either due to a genetic mutation affecting the V2 receptor or acquired due to various factors such as lithium toxicity, certain medications, or chronic kidney disease. When ADH binds to the V2 receptor, it triggers an increase in aquaporin-2 water channels, allowing water reabsorption in the collecting ducts. In NDI, this process is impaired, leading to polyuria.

**Why Each Wrong Option is Incorrect**
**Option A:** Certain medications, such as lithium, can cause NDI by inhibiting the V2 receptor, making this option incorrect.
**Option B:** Genetic mutations affecting the V2 receptor can cause hereditary NDI, making this option incorrect.
**Option C:** Chronic kidney disease can lead to NDI by causing damage to the renal collecting ducts, making this option incorrect.

**Clinical Pearl / High-Yield Fact**
Hereditary NDI is inherited in an X-linked recessive pattern, primarily affecting males due to the location of the V2 receptor gene on the X chromosome.

**Correct Answer: D.**