Thiazides - treatment of nephrogenic Diabetes inspidus how???

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Thiazides diuretics are given in treatment of nephrogenic diabetes mellitus. Why?

In nephrogenic DI the kidneys are unable to respond to ADH and therefore water loss, and we use thiazides in treatment…
Discuss it

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Thiazides cause mild dehydration, hence body tries to save water, So the kidneys reabsorb more water in the proximal tubule. Less water reaches the part that’s unresponsive and less urine output
Net result- Paradoxically ↓ urine volume

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They help by causing mild volume depletion, which leads the kidneys to reabsorb more sodium and water in the proximal tubule. This reduces the amount of water reaching the distal parts of the nephron, where the ADH resistance exists—so, overall less water is lost in urine.

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Thiazides are used in nephrogenic diabetes insipidus (NDI) because they:

  1. Induce mild volume contraction, increasing proximal tubular reabsorption of sodium and water.
  2. Reduce urine volume by enhancing water reabsorption.

This paradoxical effect helps manage polyuria in NDI patients.

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