The Diabetes insipidus CPG has been updated and reviewed by the CPG committee and endorsed by the Paediatric Improvement Collaborative (July 2022). It includes new key points, background, assessment and management sections. There is additional detail on assessment and management of central versus nephrogenic causes of diabetes insipidus, as well as the inclusion of a new table to help differentiate causes.  

The key points for the CPG are 

1. Children with suspected or known diabetes insipidus (DI) must always have free access to water. Never restrict fluid intake 
2. Urine output may not reflect hydration status 
3. Close monitoring of electrolytes and fluid balance is required for inpatients with DI. This is particularly critical when children are too young or too unwell to adequately respond to thirst 
4. Beyond emergency resuscitation, sodium chloride containing fluids should never be given to children with nephrogenic DI without specialist consultation