Hong E G, Suh Y, Chung Y S, Kim H M, Shin G T, Chung D Y, Park R W
Department of Endocrinology, Ajou University School of Medicine, Suwon, Korea.
Yonsei Med J. 2000 Feb;41(1):150-4. doi: 10.3349/ymj.2000.41.1.150.
Nephrogenic diabetes insipidus (DI) secondary to chronic urinary tract obstruction is a rare disease. The exact cause is unknown but it is likely that increased collecting duct pressures cause damage to the tubular epithelium, resulting in insensitivity to the action of arginine-vasopressin (AVP). A 77-year-old man complaining of polyuria and polydipsia was treated with alpha glucosidase inhibitor under the impression of polyuria due to diabetes mellitus. But his symptoms did not improve. Water deprivation and AVP administration study revealed that the patient had nephrogenic DI. Urinary tract obstruction due to an enlarged prostate was suggested as a principal cause of nephrogenic DI. The patient underwent transurethral resection of the prostate and bilateral subcapsular orchiectomy. After surgery, the urine osmolarity was normalized and the patient became symptom-free. We report a case of nephrogenic DI due to obstructive uropathy which was cured by surgery eliminating obstruction.
继发于慢性尿路梗阻的肾性尿崩症(DI)是一种罕见疾病。确切病因不明,但很可能是集合管压力升高导致肾小管上皮受损,从而对精氨酸加压素(AVP)的作用产生不敏感。一名77岁男性因多尿和烦渴就诊,因糖尿病多尿而接受α-葡萄糖苷酶抑制剂治疗。但他的症状并未改善。禁水-加压素试验显示该患者患有肾性尿崩症。前列腺增生导致的尿路梗阻被认为是肾性尿崩症的主要原因。该患者接受了经尿道前列腺切除术和双侧睾丸包膜下切除术。术后,尿渗透压恢复正常,患者症状消失。我们报告一例因梗阻性肾病导致的肾性尿崩症病例,通过手术解除梗阻而治愈。