The perioperative challenge of nephrogenic diabetes insipidus: A multidisciplinary approach

Nephrogenic Diabetes Insipidus (NDI) is characterised by the inability of the kidneys to concentrate urine in response to arginine vasopressin (AVP). Such patients typically experience polyuria and polydipsia because of this inability to autoregulate their water balance. This provides a perioperativ...

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Bibliographic Details
Published in:The surgeon (Edinburgh) 2005-04, Vol.3 (2), p.89-94
Main Authors: Moug, S.J., McKee, R.F., O’Reilly, D.St.J., Noble, S., Boulton-Jones, M.
Format: Article
Language:English
Subjects:
Anastomosis, Surgical
Biological and medical sciences
Diabetes Insipidus, Nephrogenic - physiopathology
Diabetes Insipidus, Nephrogenic - prevention & control
Female
General aspects
Humans
Ileum - surgery
Kidneys
Medical sciences
Middle Aged
Nephrogenic diabetes insipidus
Nephrology. Urinary tract diseases
Perioperative Care - methods
Rectum - surgery
serum sodium
Urinary system involvement in other diseases. Miscellaneous
water balance
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Summary:Nephrogenic Diabetes Insipidus (NDI) is characterised by the inability of the kidneys to concentrate urine in response to arginine vasopressin (AVP). Such patients typically experience polyuria and polydipsia because of this inability to autoregulate their water balance. This provides a perioperative challenge that could lead to a life-threatening situation. This article documents a patient with NDI who underwent an elective bowel re-anastomosis. Two peak serum sodium values were attained. The first when the patient was retaining sodium due to an inappropriate fluid regimen and the second due to hypovolaemia. The literature is reviewed and principles for NDI perioperative management are proposed
ISSN:1479-666X
2405-5840
DOI:10.1016/S1479-666X(05)80068-X