Al Nofal Alaa, Lteif Aida
Division of Pediatric Endocrinology, Mayo Clinic, Rochester, MN; Evidence-Based Practice Research Program, Mayo Clinic, Rochester, MN.
Division of Pediatric Endocrinology, Mayo Clinic, Rochester, MN.
J Pediatr. 2015 Sep;167(3):658-61. doi: 10.1016/j.jpeds.2015.06.002. Epub 2015 Jun 27.
To report our experience in treating infants and toddlers with central diabetes insipidus (DI) with thiazide diuretics.
A retrospective chart review of all infants and toddlers who were treated with thiazide diuretics for central DI at the Mayo Clinic between 1996 and 2014.
Our cohort consisted of 13 patients. The median age at the start of therapy was 6 months (IQR, 1-14 months). Eight patients were given chlorothiazide at a starting dose of 5-10 mg/kg/day, and 5 patients were treated with hydrochlorothiazide at a starting dose of 1-2 mg/kg/day. The median age at the cessation of thiazide therapy was 18 months (IQR, 11.5-39 months). The main reason for stopping was the lack of continued response, in addition to hypernatremia. There was no hospitalization secondary to hyponatremia and only 1 hospitalization secondary to hypernatremia while receiving thiazide therapy. Calcium was checked periodically in 7 of the 13 patients, and 2 of these 7 patients had persistent hypercalcemia.
Thiazide diuretics appear to be safe and effective in treating infants with central DI. They can be continued after the introduction of solid food, and until a lack of response is observed.
报告我们使用噻嗪类利尿剂治疗婴幼儿中枢性尿崩症（DI）的经验。
对1996年至2014年间在梅奥诊所接受噻嗪类利尿剂治疗中枢性DI的所有婴幼儿进行回顾性病历审查。
我们的队列包括13名患者。治疗开始时的中位年龄为6个月（四分位间距，1 - 14个月）。8名患者接受氯噻嗪治疗，起始剂量为5 - 10mg/kg/天，5名患者接受氢氯噻嗪治疗，起始剂量为1 - 2mg/kg/天。噻嗪类利尿剂治疗停止时的中位年龄为18个月（四分位间距，11.5 - 39个月）。除高钠血症外，停止治疗的主要原因是缺乏持续反应。接受噻嗪类利尿剂治疗期间，没有因低钠血症导致的住院情况，仅有1次因高钠血症导致的住院。13名患者中有7名定期检查钙水平，这7名患者中有2名持续存在高钙血症。
噻嗪类利尿剂在治疗婴幼儿中枢性DI方面似乎安全有效。在引入固体食物后可以继续使用，直至观察到缺乏反应。
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