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Treatment of nephrogenic diabetes insipidus with hydrochlorothiazide and amiloride.

Abstract
Nephrogenic diabetes insipidus (NDI) is characterised by the inability of the kidney to concentrate urine in response to arginine vasopressin. The consequences are severe polyuria and polydipsia, often associated with hypertonic dehydration. Intracerebral calcification, seizures, psychosomatic retardation, hydronephrosis, and hydroureters are its sequelae. In this study, four children with NDI were treated with 3 mg/kg/day hydrochlorothiazide and 0.3 mg/kg/day amiloride orally three times a day for up to five years. While undergoing treatment, none of the patients had signs of dehydration or electrolyte imbalance, all showed normal body growth, and there was no evidence of cerebral calcification or seizures. All but one had normal psychomotor development and normal sonography of the urinary tract. However, normal fluid balance was not attainable (fluid intake, 3.8-7.7 l/m2/day; urine output, 2.2-7.4 l/m2/day). The treatment was well tolerated and no side effects could be detected. Prolonged treatment with hydrochlorothiazide/amiloride appears to be more effective and better tolerated than just hydrochlorothiazide. Its efficacy appears to be similar to that of hydrochlorothiazide/indomethacin but without their severe side effects.
AuthorsV Kirchlechner, D Y Koller, R Seidl, F Waldhauser
JournalArchives of disease in childhood (Arch Dis Child) Vol. 80 Issue 6 Pg. 548-52 (Jun 1999) ISSN: 1468-2044 [Electronic] England
PMID10332005 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Diuretics
  • Sodium Chloride Symporter Inhibitors
  • Hydrochlorothiazide
  • Amiloride
Topics
  • Amiloride (therapeutic use)
  • Child Development
  • Child, Preschool
  • Diabetes Insipidus, Nephrogenic (drug therapy, physiopathology)
  • Diuretics (therapeutic use)
  • Drug Therapy, Combination
  • Female
  • Humans
  • Hydrochlorothiazide (therapeutic use)
  • Infant
  • Infant, Newborn
  • Male
  • Sodium Chloride Symporter Inhibitors (therapeutic use)

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