THE URINARY output is normally determined to a large extent by the fluid intake. In certain pathologic states, the regulatory mechanism may be so disturbed that the urinary excretion of water becomes excessive, resulting in dehydration despite a theoretically adequate fluid intake. Excessive excretion of renal water which cannot be attributed to the presence of some abnormal substance in urine, such as sugar, nor to a diffuse renal disease, such as glomerulonephritis or pyelonephritis, has been classified clinically as diabetes insipidus. Most cases in which this condition is present are associated with a lesion in the neurohypophysis or hypothalamic areas and are attributable to a deficiency of the antidiuretic hormone produced by the posterior lobe of the pituitary gland. Two recent reports1 have suggested that in certain cases of congenital diabetes insipidus the excessive urinary excretion may be due to an end-organ defect rather than a deficiency in hormonal
DANCIS J, BIRMINGHAM JR, LESLIE SH. CONGENITAL DIABETES INSIPIDUS RESISTANT TO TREATMENT WITH PITRESSIN. Am J Dis Child. 1948;75(3):316–328. doi:10.1001/archpedi.1948.02030020328005
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