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尿崩症:新药疗法带来的具有挑战性的诊断

Diabetes insipidus: a challenging diagnosis with new drug therapies.

作者信息

Saifan Chadi, Nasr Rabih, Mehta Suchita, Sharma Acharya Pranab, Perrera Isera, Faddoul Giovanni, Nalluri Nikhil, Kesavan Mayurakhan, Azzi Yorg, El-Sayegh Suzanne

机构信息

Division of Nephrology, Department of Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA.

出版信息

ISRN Nephrol. 2013 Mar 24;2013:797620. doi: 10.5402/2013/797620. eCollection 2013.

Abstract

Diabetes Insipidus (DI) is either due to deficient secretion of arginine vasopressin (central) or to tubular unresponsiveness (nephrogenic). Drug induced DI is a well-known entity with an extensive list of medications. Polyuria is generally defined as urine output exceeding 3 liters per day in adults. It is crucial to identify the cause of diabetes insipidus and to implement therapy as early as possible to prevent the electrolyte disturbances and the associated mortality and morbidity. It is very rare to have an idiosyncratic effect after a short use of a medication, and physicians should be aware of such a complication to avoid volume depletion. The diagnosis of diabetes insipidus is very challenging because it relies on laboratory values, urine output, and the physical examination of the patient. A high clinical suspicion of diabetes insipidus should be enough to initiate treatment. The complications related to DI are mostly related to the electrolyte imbalance that can affect the normal physiology of different organ systems.

摘要

尿崩症(DI)要么是由于精氨酸加压素分泌不足(中枢性),要么是由于肾小管无反应性(肾源性)。药物性尿崩症是一种已知的病症,涉及众多药物。多尿通常定义为成人每日尿量超过3升。识别尿崩症的病因并尽早实施治疗以预防电解质紊乱及相关的死亡率和发病率至关重要。短期使用药物后出现特异反应非常罕见,医生应意识到这种并发症以避免容量耗竭。尿崩症的诊断极具挑战性,因为它依赖于实验室检查结果、尿量以及患者的体格检查。对尿崩症的高度临床怀疑应足以启动治疗。与尿崩症相关的并发症大多与电解质失衡有关,电解质失衡会影响不同器官系统的正常生理功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2fa/4045430/699d92610ddf/ISRN.NEPHROLOGY2013-797620.001.jpg

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