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[Comment] Testing the waters: a new test for hypotonic polyuria

20:06 EDT 11 Jul 2019 | The Lancet

Three disorders can cause water diuresis (hypotonic polyuria): primary polydipsia, central diabetes insipidus, and nephrogenic diabetes insipidus. These causes of hypotonic polyuria are difficult to differentiate, especially the partial forms of central diabetes insipidus from primary polydipsia.1 Yet this differentiation is crucial because the management for each disorder is quite different. For years, hypotonic polyuria was assessed with the water-deprivation test, with subsequent measurements of plasma vasopressin (the direct test) or urine osmolality (the indirect test).

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