Fluid deprivation test

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Fluid Deprivation Test is a diagnostic procedure used to determine the causes of polyuria (excessive urination) and polydipsia (excessive thirst). These symptoms can be indicative of various conditions, including diabetes insipidus, diabetes mellitus, and psychogenic polydipsia. The test measures the body's ability to concentrate urine in response to fluid deprivation, helping to differentiate between these conditions.

Procedure

The fluid deprivation test typically begins in the morning. The patient is instructed to stop drinking fluids several hours before the test starts. During the test, the patient's weight, urine output, and urine concentration are monitored at regular intervals. Blood samples may also be taken to measure serum electrolytes and antidiuretic hormone (ADH) levels. The test continues until one of the following occurs: a significant decrease in body weight (usually 3-5% of body weight), a plateau in urine osmolality/concentration across three consecutive measurements, or the patient develops symptoms indicating the test should be stopped, such as significant discomfort or signs of dehydration.

Interpretation

The results of the fluid deprivation test help to distinguish between different types of diabetes insipidus and other conditions. If the patient's urine concentration increases significantly during the test, it suggests that the kidneys can concentrate urine normally when fluid intake is restricted, which may indicate psychogenic polydipsia or primary polydipsia. If the urine concentration remains low, it suggests a diagnosis of diabetes insipidus. Further differentiation between central (neurogenic) and nephrogenic diabetes insipidus can be made based on the response to administered ADH during the test. An increase in urine concentration after ADH administration suggests central diabetes insipidus, while little to no response suggests nephrogenic diabetes insipidus.

Risks and Considerations

The fluid deprivation test is generally safe but requires careful monitoring to avoid complications such as dehydration and electrolyte imbalance. It is contraindicated in patients with severe illness, unstable medical conditions, or those who cannot be adequately monitored during the test.

See Also

• Diabetes insipidus
• Polyuria
• Polydipsia
• Antidiuretic hormone

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