Abstract |
Central diabetes insipidus is clinically masked in dialysis patients. We report a 12-year-old girl receiving a living-related donor graft for renal failure from Alport syndrome, in whom a craniopharyngioma had been resected 6 months before transplantation. Pretransplant evaluation had documented central hypothyroidism, growth hormone deficiency, and presumptive hypogonadotropic hypogonadism. The corticotropin-releasing factor test had been normal. Four hours after transplantation, urine output exceeded 1,000 ml/h without diuretic therapy. Serum sodium concentration was 155 mmol/l, serum osmolality 333 mmol/kg, and plasma antidiuretic hormone 4.9 ng/l, while urine osmolality was 233 mmol/kg. Desmopressin acetate was started by continuous intravenous infusion at 1 microgram/day. Serum electrolytes rapidly normalized, urine output stabilized at 2 l/day. The patient was discharged 4 weeks after transplantation with good allograft function, receiving intranasal desmopressin acetate 10 micrograms twice daily. Pre-existing central diabetes insipidus is unmasked after successful kidney transplantation, leading to rapid dehydration and hypernatremia, which can be prevented by prompt institution of desmopressin therapy.
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Authors | T Henne, A Bökenkamp, G Offner, J H Ehrich |
Journal | Pediatric nephrology (Berlin, Germany)
(Pediatr Nephrol)
Vol. 16
Issue 4
Pg. 315-7
(Apr 2001)
ISSN: 0931-041X [Print] Germany |
PMID | 11354773
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Renal Agents
- Deamino Arginine Vasopressin
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Topics |
- Child
- Craniopharyngioma
(complications, diagnosis, surgery)
- Deamino Arginine Vasopressin
(therapeutic use)
- Diabetes Insipidus, Neurogenic
(complications, drug therapy)
- Female
- Humans
- Kidney Failure, Chronic
(complications, surgery)
- Kidney Transplantation
- Living Donors
- Magnetic Resonance Imaging
- Pituitary Neoplasms
(complications, diagnosis, surgery)
- Renal Agents
(therapeutic use)
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