Diabetes insipidus in children

Diabetes insipidus in children is an uncommon but important disorder of water balance characterized by excretion of large volumes of dilute urine and excessive thirst. It results from either deficiency of antidiuretic hormone or resistance of the kidneys to its action, leading to impaired renal water reabsorption and consequent hypernatremia if water intake is inadequate. Although less prevalent than diabetes mellitus, diabetes insipidus can present with significant morbidity, especially in infants and young children, where diagnosis may be delayed. Early recognition, accurate classification, and appropriate management are essential to prevent dehydration, electrolyte imbalance, and adverse neurodevelopmental outcomes. This article reviews the epidemiology, etiology, pathophysiology, clinical features, diagnosis, management, and prognosis of diabetes insipidus in children from an MBBS-level pediatric perspective.