Which medication is first-line for central diabetes insipidus?

Which medication is first-line for central diabetes insipidus?

• A. Indomethacin
• B. Amiloride
• C. Desmopressin (DDAVP)
• D. Hydrochlorothiazide

Answer: (C)

Central diabetes insipidus occurs when there isn’t enough antidiuretic hormone to signal the kidneys to concentrate urine. Replacing that missing hormone directly addresses the root problem, so urine output drops and water balance improves. Desmopressin is a synthetic vasopressin analog that acts on the kidney’s collecting ducts to promote water reabsorption, effectively normalizing urine volume and helping prevent dehydration and hypernatremia. It provides predictable, controllable therapy with dosing that can be adjusted while monitoring sodium and osmolality to avoid hyponatremia. Other medicines can help in different DI scenarios or as adjuncts (for example, certain drugs may modestly reduce urine output in nephrogenic DI), but they don’t replace the missing hormone in central DI and aren’t the first-line choice.

Central diabetes insipidus occurs when there isn’t enough antidiuretic hormone to signal the kidneys to concentrate urine. Replacing that missing hormone directly addresses the root problem, so urine output drops and water balance improves. Desmopressin is a synthetic vasopressin analog that acts on the kidney’s collecting ducts to promote water reabsorption, effectively normalizing urine volume and helping prevent dehydration and hypernatremia. It provides predictable, controllable therapy with dosing that can be adjusted while monitoring sodium and osmolality to avoid hyponatremia.

Other medicines can help in different DI scenarios or as adjuncts (for example, certain drugs may modestly reduce urine output in nephrogenic DI), but they don’t replace the missing hormone in central DI and aren’t the first-line choice.