What type of fluid is preferred for symptomatic treatment of diabetes insipidus?

For symptomatic treatment of diabetes insipidus, hypotonic fluid is preferred due to its composition and properties that align with the physiological needs of patients experiencing excessive urination and thirst associated with this condition.

Diabetes insipidus is characterized by a deficiency in antidiuretic hormone (ADH), leading to an inability to concentrate urine and resulting in significant fluid loss. As these patients lose large volumes of dilute urine, they can become dehydrated, which necessitates the replacement of free water rather than electrolytes.

Hypotonic fluids, such as dextrose in water (D5W) or 0.45% saline, provide free water, which is essential for managing the condition since they help to rehydrate and restore the proper osmolarity of body fluids without introducing excessive sodium. This helps alleviate the hypernatremia that can occur due to ongoing fluid loss.

In contrast, normal saline and hypertonic saline primarily supply sodium and chloride, which does not appropriately address the specific fluid loss pattern in diabetes insipidus. Colloids, while useful for volume expansion in some cases, are not indicated as the primary treatment in this scenario. Therefore, the use of hypotonic fluids is integral in correcting the fluid imbalance and preventing