Nephrogenic diabetes insipidus persisting 57 months after cessation of lithium carbonate therapy: report of a case and review of the literature.

Abstract

OBJECTIVE:

To illuminate the natural history of prolonged nephrogenic diabetes insipidus after discontinuation of lithium carbonate treatment and to assess the response to therapy with desmopressin acetate and triamterene-hydrochlorothiazide.

METHODS:

We analyzed sequential determinations of serum and urine osmolality, plasma arginine vasopressin, serum sodium, blood urea nitrogen, calcium, ionized calcium, parathyroid hormone, and 24-hour urine volume during a period of 57 months in a 67-year-old woman.

RESULTS:

Our patient experienced persistent polyuria in conjunction with having repeated serum osmolalities between 300 and 323 mOsm/kg and urine osmolalities between 130 and 208 mOsm/kg. Concomitant plasma arginine vasopressin levels were as high as 12.0 pg/mL, consistent with the diagnosis of nephrogenic diabetes insipidus. Administration of triamterene-hydrochlorothiazide reduced 24-hour urine volume and serum osmolality while increasing urine osmolality. Desmopressin acetate exhibited no effect.

CONCLUSION:

In this report, we describe the eighth documented case of persistent nephrogenic diabetes insipidus, lasting 57 months after cessation of lithium therapy, and demonstrate a palliative effect of triamterene-hydrochlorothiazide.

• Authors: A F Guirguis, H C Taylor
• Journal: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists (Endocr Pract) 2000 Jul-Aug Vol. 6 Issue 4 Pg. 324-8 ISSN: 1530-891X [Print] United States
• PMID: 11242610 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Diuretics
• Renal Agents
• Sodium Chloride Symporter Inhibitors
• Hydrochlorothiazide
• Lithium Carbonate
• Deamino Arginine Vasopressin
• Triamterene

Topics

• Aged
• Deamino Arginine Vasopressin (therapeutic use)
• Diabetes Insipidus, Nephrogenic (drug therapy, pathology)
• Diuretics (therapeutic use)
• Female
• Humans
• Hydrochlorothiazide (therapeutic use)
• Kidney (pathology)
• Lithium Carbonate (administration & dosage, therapeutic use)
• Renal Agents (therapeutic use)
• Sodium Chloride Symporter Inhibitors (therapeutic use)
• Treatment Outcome
• Triamterene (therapeutic use)