26 February 2010
Newly symptomatic central diabetes insipidus in ESRD with adult polycystic kidney disease following intracranial hemorrhage: the first reported caseMacaulay A.C. OnuigboABCDEF, Joseph SkalskiEF
Med Sci Monit 2010; 16(3): CS29-32 :: ID: 878449
Adult polycystic kidney disease (ADPKD), an autosomal dominantly inherited cause of ESRD, is often characterized by a relative renal tubular unresponsiveness to ADH. Polyuria, renal concentrating defects and generally elevated ADH levels, a form of nephrogenic diabetes insipidus (NDI) is often implicated. Thus, even late in stages of CKD, ADPKD patients often produce significant amounts of urine. Conversely, central diabetes insipidus (CDI), a clinical syndrome secondary to deficiency of ADH, also leads to production of large volumes of dilute urine, i.e. polyuria. It is widely believed that clinical CDI is masked in ESRD patients on dialysis, due to apparently obvious reasons. However, there have been published a few reports of the unmasking of polyuria secondary to previously existing CDI in ESRD patients, after kidney transplantation.
Material and Method
We report, to our knowledge, the first case of new-onset symptomatic CDI causing nocturnal polyuria in an ADPKD patient with ESRD, before now on hemodialysis. CDI symptoms were noted, months after an intracranial aneurysm clipping procedure that was complicated by intra-cranial hemorrhage. The 59-year old Caucasian woman responded moderately to desmopressin replacement therapy.
Several interesting pathobiologic implications of this case report are entertained.
Keywords: Kidney Failure, Chronic - complications, Intracranial Hemorrhages - complications, Diabetes Insipidus, Neurogenic - etiology, Polycystic Kidney, Autosomal Dominant - complications
01 November 2023 : EditorialEditorial: Factors Driving New Variants of SARS-CoV-2, Immune Escape, and Resistance to Antiviral Treatments as the End of the COVID-19 Pandemic is Declared
Med Sci Monit 2023; 29:e942960
30 Nov 2023 : Review articleDecoding the Neurological Sequelae of General Anesthesia: A Review
Med Sci Monit In Press; DOI: 10.12659/MSM.942740
30 Nov 2023 : Clinical ResearchEnhanced Pain Relief and Muscle Growth in Individuals with Low Back Instability: The Impact of Blood Flow R...
Med Sci Monit In Press; DOI: 10.12659/MSM.942508
29 Nov 2023 : Clinical ResearchComparative Analysis of Intramedullary Nail versus Plate Fixation for Fibula Fracture in Supination Externa...
Med Sci Monit In Press; DOI: 10.12659/MSM.941909
Most Viewed Current Articles
13 Nov 2021 : Clinical ResearchAcceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...
Med Sci Monit 2021; 27:e932788
30 Dec 2021 : Clinical ResearchRetrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...
Med Sci Monit 2021; 27:e935379
14 Dec 2022 : Clinical ResearchPrevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase Levels
Med Sci Monit 2022; 28:e937990
08 Mar 2022 : Review articleA Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...
Med Sci Monit 2022; 28:e936292