Abstract
Background: Arginine vasopressin disorders (AVP-T), formerly called diabetes insipidus, are a group of diseases related to arginine vasopressin (AVP) disorders. This disease is characterized by excessive hypotonic urine excretion, resulting in symptoms such as polydipsia and polyuria. Laboratory tests such as the water deprivation test, direct AVP measurement and copeptin measurement are used for diagnosis to differentiate between the different types of AVP-T that may occur. Objective: to report on current and future perspectives on arginine vasopressin disorder. Methodology: a narrative literature review was carried out by consulting the Elsevier, Medigraphic, PubMed, Scielo and Google academic databases for no more than 5 years, in Spanish and English, thus obtaining from the thorough and rigorous search several scientific articles with relevant information for the subject. Conclusions: copeptin is a promising biomarker in the diagnosis of PVA-T, since it reflects changes in plasma osmolarity and responds rapidly to fluid intake. Regarding treatment, desmopressin remains the drug of choice to control and treat the disease. Results: New therapeutic options for primary polydipsia such as glucagon-like peptide-1 (GLP-1) receptor agonists are being investigated and promise to be an effective drug.
References
Refardt J, Winzeler B, Christ M. Diabetes Insipidus: An Update. Endocrinology and Metabolism Clinics of North America [Internet]. 2020 [citado el 6 de mayo de 2024];49(3):517–31. Disponible en: https://www.sciencedirect.com/science/article/pii/S0889852920300396
Christ M, Gaisl O. Diabetes insipidus. La Presse Médicale [Internet]. 2021 [citado el 6 de mayo de 2024];50(4):104093. Disponible en: https://www.sciencedirect.com/science/article/pii/S0755498221000300
Patti G, Ibba A, Morana G, Napoli F, Fava D, di Iorgi N, et al. Central diabetes insipidus in children: Diagnosis and management. Best Practice & Research Clinical Endocrinology & Metabolism [Internet]. 2020 [citado el 30 de mayo de 2024];34(5):101440. Disponible en: https://www.sciencedirect.com/science/article/pii/S1521690X20300671
Christ M, Winzeler B, Refardt J. Diagnosis and management of diabetes insipidus for the internist: an update. Journal of Internal Medicine [Internet]. 2021 [citado el 7 de mayo de 2024];290(1):73–87. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1111/joim.13261
Weiner A, Vuguin P. Diabetes Insipidus. Pediatr Rev [Internet]. febrero de 2020;41(2):96–9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32005690/
Ananthakrishnan S. Gestational diabetes insipidus: Diagnosis and management. Best Pract Res Clin Endocrinol Metab [Internet]. septiembre de 2020;34(5):101384. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32205050/
Christ-Crain M. Diabetes Insipidus: New Concepts for Diagnosis. Neuroendocrinology [Internet]. el 2 de enero de 2020 [citado el 30 de mayo de 2024];110(9–10):859–67. Disponible en: https://doi.org/10.1159/000505548
Chong PL, Pisharam J, Abdullah A, Chong VH. Gestational diabetes insipidus. QJM: An International Journal of Medicine [Internet]. el 1 de febrero de 2019 [citado el 30 de mayo de 2024];112(2):123–4. Disponible en: https://academic.oup.com/qjmed/article/112/2/123/5146316
Arima H, Cheetham T, Christ M, Cooper D, Gurnell M, Drummond JB, et al. Changing the name of diabetes insipidus: a position statement of The Working Group for Renaming Diabetes Insipidus. Endocrine Journal [Internet]. 2022;69(11):1281–4. Disponible en: 10.1507/endocrj.EJ20220831
Levy M, Prentice M, Wass J. Diabetes insipidus. BMJ [Internet]. 2019;364:l321. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30819684/
Harrois A, Anstey JR. Diabetes Insipidus and Syndrome of Inappropriate Antidiuretic Hormone in Critically Ill Patients. Crit Care Clin [Internet]. abril de 2019;35(2):187–200. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30784603/
Kavanagh C, Uy NS. Nephrogenic Diabetes Insipidus. Pediatr Clin North Am [Internet]. 2019;66(1):227–34. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30454745/
Balla A, Hunyady L. Nephrogenic Diabetes Insipidus. Exp Suppl [Internet]. 2019;111:317–39. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31588538/
Refardt J, Christ-Crain M. Diabetes insipidus in pregnancy: how to advice the patient? Minerva Endocrinol [Internet]. diciembre de 2018;43(4):458–64. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29463074/
Mutter C, Smith T, Menze O, Zakharia M, Nguyen H. Diabetes Insipidus: Pathogenesis, Diagnosis, and Clinical Management. Cureus [Internet]. 2021;13(2):e13523. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996474/
Maldonado K, Lara V, Criollo K, Andino H. Metodologías diagnósticas y etiologías como diagnósticos diferenciales en pacientes con diabetes insípida central. 2023 [citado el 29 de mayo de 2024];9(4). Disponible en: https://doi.org/10.23857/dc.v9i4.3643
Christ-Crain M, Bichet DG, Fenske WK, Goldman MB, Rittig S, Verbalis JG, et al. Diabetes insipidus. Nat Rev Dis Primers [Internet]. el 8 de agosto de 2019;5(1):54. Disponible en: https://doi.org/10.1038/s41572-019-0103-2
Christ M. New diagnostic approaches for patients with polyuria polydipsia syndrome. European Journal of Endocrinology [Internet]. julio de 2019 [citado el 31 de mayo de 2024];181(1):R11–21. Disponible en: https://academic.oup.com/ejendo/article/181/1/R11/6654173
Refardt J, Winzeler B, Christ-Crain M. Copeptin and its role in the diagnosis of diabetes insipidus and the syndrome of inappropriate antidiuresis. Clinical Endocrinology [Internet]. 2019 [citado el 30 de mayo de 2024];91(1):22–32. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1111/cen.13991
Atila C, Gaisl O, Vogt DR, Werlen L, Szinnai G, Christ-Crain M. Glucagon-stimulated copeptin measurements in the differential diagnosis of diabetes insipidus: a double-blind, randomized, placebo-controlled study. Eur J Endocrinol [Internet]. el 12 de mayo de 2022;187(1):65–74. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35521789/
Pascual-Corrales E, Araujo-Castro M, Ortiz-Flores AE, Escobar-Morreale HF. Diabetes insípida. Medicine - Programa de Formación Médica Continuada Acreditado [Internet]. el 1 de octubre de 2020;13:993–9. Disponible en: https://www.researchgate.net/publication/346336015_Diabetes_insipida
Christ-Crain M, Refardt J, Winzeler B. Approach to the Patient: “Utility of the Copeptin Assay”. The Journal of Clinical Endocrinology & Metabolism [Internet]. el 17 de mayo de 2022 [citado el 30 de mayo de 2024];107(6):1727–38. Disponible en: https://academic.oup.com/jcem/article/107/6/1727/6524226
Winzeler B, Cesana-Nigro N, Refardt J, Vogt DR, Imber C, Morin B, et al. Arginine-stimulated copeptin measurements in the differential diagnosis of diabetes insipidus: a prospective diagnostic study. Lancet. el 17 de agosto de 2019;394(10198):587–95.
Fenske Wiebke, Refardt Julie, Chifu Irina, Schnyder Ingeborg, Winzeler Bettina, Drummond Juliana, et al. A Copeptin-Based Approach in the Diagnosis of Diabetes Insipidus. New England Journal of Medicine [Internet]. 2018 [citado el 30 de mayo de 2024];379(5):428–39. Disponible en: https://www.nejm.org/doi/full/10.1056/NEJMoa1803760
Refardt J, Christ-Crain M. Copeptin-based diagnosis of diabetes insipidus. Swiss Med Wkly [Internet]. el 6 de mayo de 2020 [citado el 30 de mayo de 2024];150(1920):w20237. Disponible en: https://smw.ch/index.php/smw/article/view/2792
Priya G, Kalra S, Dasgupta A, Grewal E. Diabetes Insipidus: A Pragmatic Approach to Management. Cureus [Internet]. el 5 de enero de 2021 [citado el 31 de mayo de 2024]; Disponible en: https://www.cureus.com/articles/46191-diabetes-insipidus-a-pragmatic-approach-to-management
Naimovna BN, Ziyouddin A, Parvina U, Sitora M, Dilsora B. Modern Methods of diagnosis and treatment of central diabetes insipidus. JOURNAL OF HEALTHCARE AND LIFE-SCIENCE RESEARCH [Internet]. el 30 de marzo de 2024 [citado el 30 de mayo de 2024];3(3):161–7. Disponible en: https://jhlsr.innovascience.uz/index.php/jhlsr/article/view/478
Gubbi S, Hannah-Shmouni F, Koch CA, Verbalis JG. Diagnostic Testing for Diabetes Insipidus. En: Feingold KR, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E, et al., editores. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2022 [citado el 31 de mayo de 2024]. Disponible en: http://www.ncbi.nlm.nih.gov/books/NBK537591/
Teare H, Argente J, Dattani M, Leger J, Maghnie M, Sherlock M, et al. Challenges and improvement needs in the care of patients with central diabetes insipidus. Orphanet Journal of Rare Diseases [Internet]. el 16 de febrero de 2022 [citado el 31 de mayo de 2024];17(1):58. Disponible en: https://doi.org/10.1186/s13023-022-02191-2
Hui C, Khan M, Khan M, Radbel J. Arginine Vasopressin Disorder (Diabetes Insipidus). En: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [citado el 7 de mayo de 2024]. Disponible en: http://www.ncbi.nlm.nih.gov/books/NBK470458/
Mejorado M, Soriano L. Diabetes insípida. Enfoque diagnóstico y terapéutico. Revista Española Endocrinología Pediátrica [Internet]. junio de 2021 [citado el 29 de mayo de 2024];12(2):56–66. Disponible en: https://doi.org/10.3266/RevEspEndocrinolPediatr.pre2021.Apr.644
UpToDate [Internet]. 2023 [citado el 7 de mayo de 2024]. Arginine vasopressin deficiency (central diabetes insipidus): Treatment - UpToDate. Disponible en: https://www-uptodate-com.vpn.ucacue.edu.ec/contents/arginine-vasopressin-deficiency-central-diabetes-insipidus-treatment?search=diabetes%20ins%C3%ADpida&source=search_result&selectedTitle=2%7E150&usage_type=default&display_rank=2#H2
Hui C, Khan M, Khan M, Radbel J. Arginine Vasopressin Disorder (Diabetes Insipidus). En: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [citado el 7 de mayo de 2024]. Disponible en: http://www.ncbi.nlm.nih.gov/books/NBK470458/
Hureaux M, Vargas-Poussou R. Genetic basis of nephrogenic diabetes insipidus. Molecular and Cellular Endocrinology [Internet]. el 15 de enero de 2023 [citado el 30 de mayo de 2024];560:111825. Disponible en: https://doi.org/10.1016/j.mce.2022.111825
Jasmeen J, Nyirenda PV, Khurana N, Mishra R, Chaudhary J, Duggal N. Diabetes Insipidus: Types, Diagnosis and Management. BIO Web Conf [Internet]. 2024 [citado el 31 de mayo de 2024];86:01016. Disponible en: https://www.bio-conferences.org/articles/bioconf/abs/2024/05/bioconf_rtbs2024_01016/bioconf_rtbs2024_01016.html
Ahmadi L, Goldman MB. Primary polydipsia: Update. Best Pract Res Clin Endocrinol Metab [Internet]. 2020;34(5):101469. Disponible en: https://doi.org/10.1016/j.beem.2020.101469
Winzeler B, Sailer CO, Coynel D, Zanchi D, Vogt DR, Urwyler SA, et al. A randomized controlled trial of the GLP-1 receptor agonist dulaglutide in primary polydipsia. J Clin Invest [Internet]. el 15 de octubre de 2021;131(20):e151800. Disponible en: https://doi.org/10.1172/JCI151800
Vukajlovic T, Sailer CO, Asmar A, Jensen BL, Vogt DR, Christ-Crain M, et al. Effect of a 3-Week Treatment with GLP-1 Receptor Agonists on Vasoactive Hormones in Euvolemic Participants. The Journal of Clinical Endocrinology & Metabolism [Internet]. el 1 de junio de 2022 [citado el 31 de mayo de 2024];107(6):e2581–9. Disponible en: https://doi.org/10.1210/clinem/dgac063
Venkatesan K, Chidambaram K, Paulsamy P, Ramaiah R, Al-Qahtani A, Venkatesan K, et al. A Subset of Primary Polydipsia, “Dipsogneic Diabetes Insipidus”, in Apparently Healthy People Due to Excessive Water Intake: Not Enough Light to Illuminate the Dark Tunnel. Healthcare [Internet]. 2021 [citado el 31 de mayo de 2024];9(4):406. Disponible en: https://www.mdpi.com/2227-9032/9/4/406
Martínez AY, Camberos J, Ibarra A. Tipos, Causas y Manifestaciones Clínicas de la Diabetes Insípida: Una Visión Integral. Ciencia Latina Revista Científica Multidisciplinar [Internet]. 2023 [citado el 30 de mayo de 2024];7(4):10415–25. Disponible en: https://www.ciencialatina.org/index.php/cienciala/article/view/7756
Atila C, Beck J, Refardt J, Erlic Z, Drummond JB, Sailer CO, et al. Psychopathological characteristics in patients with arginine vasopressin deficiency (central diabetes insipidus) and primary polydipsia compared to healthy controls. European Journal of Endocrinology [Internet]. 2024 [citado el 30 de mayo de 2024];190(5):354–62. Disponible en: https://academic.oup.com/ejendo/article/190/5/354/7637313
Refardt J. Diagnosis and differential diagnosis of diabetes insipidus: Update. Best Practice & Research Clinical Endocrinology & Metabolism [Internet]. el 1 de septiembre de 2020 [citado el 14 de mayo de 2024];34(5):101398. Disponible en: https://www.sciencedirect.com/science/article/pii/S1521690X20300257
Tomkins M, Lawless S, Martin-Grace J, Sherlock M, Thompson CJ. Diagnosis and Management of Central Diabetes Insipidus in Adults. The Journal of Clinical Endocrinology & Metabolism [Internet]. el 1 de octubre de 2022 [citado el 14 de mayo de 2024];107(10):2701–15. Disponible en: https://doi.org/10.1210/clinem/dgac381
Pedersen. Aslak, Andreassen, Mikkel, Rasmussen, Aase, Krogh, Jesper. Desmopressin Dose Requirements in Adults with Congenital and Acquired Central Diabetes Insipidus. 2024 [citado el 31 de mayo de 2024];56(3):206–13. Disponible en: https://www.thieme-connect.com/products/ejournals/html/10.1055/a-2198-7207
de Vries F, Lobatto DJ, Verstegen MJT, van Furth WR, Pereira AM, Biermasz NR. Postoperative diabetes insipidus: how to define and grade this complication? Pituitary [Internet]. 2021 [citado el 14 de mayo de 2024];24(2):284–91. Disponible en: https://doi.org/10.1007/s11102-020-01083-7
Garrahy A, Thompson C. Management of central diabetes insipidus. Best Practice & Research Clinical Endocrinology & Metabolism [Internet]. 2020 [citado el 7 de mayo de 2024];34(5):101385. Disponible en: https://www.sciencedirect.com/science/article/pii/S1521690X20300129
de Groot T, Sinke AP, Kortenoeven MLA, Alsady M, Baumgarten R, Devuyst O, et al. Acetazolamide Attenuates Lithium–Induced Nephrogenic Diabetes Insipidus. Journal of the American Society of Nephrology [Internet]. julio de 2016 [citado el 30 de mayo de 2024];27(7):2082. Disponible en: https://journals.lww.com/jasn/fulltext/2016/07000/acetazolamide_attenuates_lithium_induced.24.aspx
Mortensen LA, Bistrup C, Jensen BL, Hinrichs GR. A mini-review of pharmacological strategies used to ameliorate polyuria associated with X-linked nephrogenic diabetes insipidus. American Journal of Physiology-Renal Physiology [Internet]. el 1 de noviembre de 2020 [citado el 31 de mayo de 2024];319(5):F746–53. Disponible en: https://journals.physiology.org/doi/10.1152/ajprenal.00339.2020
Du Plessis W, Chothia M. Congenital nephrogenic diabetes insipidus treated with acetazolamide. Nephrology [Internet]. [citado el 31 de mayo de 2024];n/a(n/a). Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1111/nep.14291
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2025 Ana Gabriela Barros-Peláez, Kevin Andrés Quituizaca-Rivera, Joffre Ismael Quito-Morocho , Lisseth Stephany Ochoa-Guzhñay