Antidiuretic hormone is released by the pituitary gland, and is responsible for regulating water absorption at the distal nephron level, specifically in the renal collecting tubule. This occurs by binding to its type 2 receptor which generates the induction of aqueous channels towards the basolateral membrane of the main cells of the kidney. When diabetes insipidus occurs, patients have a state of decreased secretion or peripheral resistance of this hormone in its receptor, so that water is not reabsorbed, it is abundantly eliminated and this generates hydroelectrolyte imbalances. This article will review the biology of the antidiuretic hormone, physiology, hydroelectrolytic alterations and based on the understanding of the altered mechanisms, its association with the management of diabetes insipidus.