{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T03:19:09Z","timestamp":1781061549197,"version":"3.54.1"},"reference-count":30,"publisher":"The Endocrine Society","issue":"2","license":[{"start":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T00:00:00Z","timestamp":1723766400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Investigation and management of hypotonic polyuria is a common challenge in clinical endocrinology. The 3 main causes, recently renamed to arginine vasopressin deficiency (AVP-D, formerly central diabetes insipidus), arginine vasopressin resistance (AVP-R, formerly nephrogenic diabetes insipidus), and primary polydipsia (PP) require accurate diagnosis, as management differs for each. This new nomenclature more accurately reflects pathophysiology and has now been adopted by the Systemized Nomenclature of Medicine (SNOMED). Advances in diagnosis over the last few years have centered around the use of copeptin measurement. Here, we use 3 patient case histories to highlight the use of this approach, and to demonstrate how it can succeed where other approaches, such as the water deprivation test, sometimes fail. We discuss the overall approach to each type of patient and the strengths and limitations of diagnostic strategies, illustrating the use of the new nomenclature.<\/jats:p>","DOI":"10.1210\/clinem\/dgae565","type":"journal-article","created":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T09:20:45Z","timestamp":1723800045000},"page":"e506-e514","source":"Crossref","is-referenced-by-count":18,"title":["Approach to the Patient With Suspected Hypotonic Polyuria"],"prefix":"10.1210","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0835-5493","authenticated-orcid":false,"given":"John","family":"Newell-Price","sequence":"first","affiliation":[{"name":"School of Medicine and Population Health, University of Sheffield , Sheffield S10 2RX ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Beaudette","family":"Drummond","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais , Belo Horizonte MG - CEP 31270-901 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5745-6832","authenticated-orcid":false,"given":"Mark","family":"Gurnell","sequence":"additional","affiliation":[{"name":"Institute of Metabolic Science & Department of Medicine, University of Cambridge & Addenbrooke's Hospital, Cambridge Biomedical Campus , Cambridge CB2 0QQ ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miles","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, University Hospitals of Leicester NHS Trust , Leicester LE3 9QP ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2859-5566","authenticated-orcid":false,"given":"Ann","family":"McCormack","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, St Vincent's Hospital , Sydney, NSW 2010 ,","place":["Australia"]},{"name":"Hormones and Cancer Group, Garvan Institute of Medical Research , Sydney, NSW 2010 ,","place":["Australia"]},{"name":"St. Vincent's Clinical School, University of New South Wales , Sydney, NSW 2052 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Cooper","sequence":"additional","affiliation":[{"name":"The Pituitary Foundation , Bristol BS2 8PE ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Wass","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, University of Oxford, Churchill Hospital , Oxford OX3 7LE ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6336-0965","authenticated-orcid":false,"given":"Mirjam","family":"Christ-Crain","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, University Hospital and University of Basel , CH-4031 Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3704-2119","authenticated-orcid":false,"given":"Joseph G","family":"Verbalis","sequence":"additional","affiliation":[{"name":"Georgetown-Howard Universities Center for Clinical and Translational Science, Georgetown University , Washington, DC 20007 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2024,8,16]]},"reference":[{"issue":"1","key":"2025012110291925200_dgae565-B1","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1038\/s41572-019-0103-2","article-title":"Diabetes insipidus","volume":"5","author":"Christ-Crain","year":"2019","journal-title":"Nat Rev Dis Primers"},{"issue":"1","key":"2025012110291925200_dgae565-B2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1210\/clinem\/dgac547","article-title":"Changing the name of diabetes insipidus: a position 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