Nephrogenic diabetes insipidus secondary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

AVPR2is the only gene known to be associated with X-linked nephrogenetic diabetes insipidus. AQP2is the only gene known to be associated with autosomal recessive and autosomal dominant nephrogenetic diabetes insipidus.

Secondary Prevention

Surveillance

  • Monitoring of growth in infants and children
  • Periodic measurement of serum sodium concentration to identify unrecognized hyperosmolality and early dehydration. Note: Urine output and urine specific gravity are useless as indicators of hydration status.
  • Annual renal ultrasound evaluation to monitor for hydronephrosis and megacystis [Shalev et al 2004]

Testing of Relatives at Risk

It is appropriate to evaluate at-risk infants as early as possible to allow for prompt diagnosis and treatment to reduce morbidity from hypernatremia, dehydration, and dilation of the urinary tract

Molecular Genetic Testing

Clinical Uses

  • Diagnostic testing
  • Carrier testing
  • Prenatal diagnosis

Clinical Testing

  • Sequence analysis
  • Sequence analysis of the AVPR2 gene detects almost 95% of disease-causing mutations in individuals with X-linked NDI.
  • Sequence analysis of the AQP2 gene detects almost 95% of disease-causing mutations in individuals with autosomal recessive or autosomal dominant NDI.
  • Linkage analysis. Linkage analysis may be performed:
  • To confirm cosegregation of a potential pathogenic mutation with disease in individual families and
  • As an ancillary test to obtain preliminary data prior to the completion of sequence analysis. Linkage testing cannot be used to confirm the diagnosis of NDI [Arthus et al 2000].

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