Perioperative management of central diabetes insipidus in kidney transplantation View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2001-04

AUTHORS

T. Henne, Arend Bökenkamp, Gisela Offner, Jochen H. H. Ehrich

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. More... »

PAGES

315-317

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s004670100571

DOI

http://dx.doi.org/10.1007/s004670100571

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1005595393

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/11354773


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