Abordagem diagnóstica e terapêutica no diabetes insipidus: elaboração de um protocolo clínico

Abstract

Diabetes Insipidus (DI) is a syndrome characterized by polyuria and polydipsia, resulting from the inability to concentrate on urine due to alterations in the secretion or action of the antidiuretic hormone (ADH). Its diagnostic approach is complex, involving the differentiation between its central, nephrogenic, gestational, and dipsogenic forms, which directly impacts the therapeutic choice. The absence of a standardized care pathway can lead to diagnostic delays and inadequate treatments. The objective of this study was to develop a clinical protocol to guide the diagnostic and therapeutic approach to Diabetes Insipidus at Hospital de Clínicas da Universidade Federal de Uberlândia - Empresa Brasileira de Serviços Hospitalares (HC-UFU/EBSERH). To this end, a comprehensive review of the scientific literature on the topic was conducted, consulting articles, guidelines, and consensus statements published in the main databases. Based on the gathered evidence, a detailed flowchart was developed that guides from the initial clinical suspicion, through diagnostic tests, such as the water deprivation test and the response to desmopressin, to the institution of specific therapy for each DI etiology. It is concluded that the proposed clinical protocol is a valuable tool to standardize practice, optimize the differential diagnosis, and ensure safer and more effective therapeutic management, aiming to improve clinical outcomes and the quality of life of patients treated at the institution.