TY - JOUR
T1 - Pre-existing undiagnosed central diabetes insipidus unmasked after renal transplantation
AU - Munoz-Mendoza, Jerson
AU - Pinto Miranda, Veronica
AU - Kupin, Warren L.
PY - 2013/2
Y1 - 2013/2
N2 - Central diabetes insipidus (CDI) is characterized clinically by the presence of polyuria with the subsequent development of volume depletion and hypernatremia. In patients with dialysis-dependent end-stage renal disease (ESRD), neither of these findings can be expressed due to the absence of renal function. A 59-year-old woman with anuric ESRD of unknown etiology had been on peritoneal dialysis for 8 years prior to receiving a cadaveric allograft. Postoperatively, she developed persistent polyuria and hypernatremia. A desmopressin test confirmed the diagnosis of CDI. A magnetic resonance imaging (MRI) of the brain revealed an empty sella turcica. Maintenance therapy with intranasal desmopressin resulted in complete resolution of the polyuria. At 6-month follow-up on daily desmopressin, the patient maintains normal serum sodium levels and stable allograft function. This is a unique case of CDI from empty sella syndrome (ESS) that was unmasked only after the restoration of normal renal function following successful renal transplantation.
AB - Central diabetes insipidus (CDI) is characterized clinically by the presence of polyuria with the subsequent development of volume depletion and hypernatremia. In patients with dialysis-dependent end-stage renal disease (ESRD), neither of these findings can be expressed due to the absence of renal function. A 59-year-old woman with anuric ESRD of unknown etiology had been on peritoneal dialysis for 8 years prior to receiving a cadaveric allograft. Postoperatively, she developed persistent polyuria and hypernatremia. A desmopressin test confirmed the diagnosis of CDI. A magnetic resonance imaging (MRI) of the brain revealed an empty sella turcica. Maintenance therapy with intranasal desmopressin resulted in complete resolution of the polyuria. At 6-month follow-up on daily desmopressin, the patient maintains normal serum sodium levels and stable allograft function. This is a unique case of CDI from empty sella syndrome (ESS) that was unmasked only after the restoration of normal renal function following successful renal transplantation.
KW - central diabetes insipidus
KW - empty sella syndrome
KW - end-stage kidney disease
KW - renal transplantation
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U2 - 10.1093/ckj/sfs170
DO - 10.1093/ckj/sfs170
M3 - Article
AN - SCOPUS:84873369854
VL - 6
SP - 81
EP - 83
JO - Clinical Kidney Journal
JF - Clinical Kidney Journal
SN - 2048-8505
IS - 1
ER -