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Lithium-induced nephrogenic diabetes insipidus after coronary artery bypass.

Abstract
We present a case of nephrogenic diabetes insipidus that occurred after on-pump coronary artery bypass grafting in a patient taking long-term lithium carbonate. Lithium toxicity (2.79 mmol/L) was identified on postoperative day 9. Serum sodium peaked at 175 mmol/L on postoperative day 21. Serum osmolality peaked at 384 mOsm/kg H2O, with a urinary osmolality of 403 mOsm/kg H2O. The patient was ultimately managed with hemofiltration and high-dose 1-desamino-8-D-arginine-vasopressin. Recommendations are made based on our experience of this case. In patients on long-term lithium therapy, the potentially life-threatening complication of lithium-induced nephrogenic diabetes insipidus should be specifically anticipated and managed.
AuthorsMatthew F Leeman, Alain Vuylsteke, Andrew J Ritchie
JournalThe Annals of thoracic surgery (Ann Thorac Surg) Vol. 84 Issue 2 Pg. 656-7 (Aug 2007) ISSN: 1552-6259 [Electronic] Netherlands
PMID17643658 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Lithium Carbonate
  • Deamino Arginine Vasopressin
Topics
  • Bipolar Disorder (drug therapy)
  • Coronary Artery Bypass
  • Coronary Disease (surgery)
  • Deamino Arginine Vasopressin (therapeutic use)
  • Diabetes Insipidus (chemically induced, therapy)
  • Hemofiltration
  • Humans
  • Lithium Carbonate (adverse effects)
  • Male
  • Middle Aged
  • Postoperative Complications (chemically induced)
  • Treatment Outcome

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