Diabetes insipidus

Levy, Miles; Prentice, Malcolm; Wass, John

doi:10.1136/bmj.l321

Cited by 14 publications

(9 citation statements)

References 8 publications

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“…Results of a retrospective audit of patients hospitalized with central DI showed that desmopressin treatment had been missed or delayed in 88% of admissions and that 35% of patients consequently developed dysnatraemia [79]. This was attributed to a lack of understanding of the critical nature of desmopressin amongst clinical staff [80]. Therefore, the Society for Endocrinology (SfE) in 2018 published guidelines on in-hospital management of central DI [81].…”

Section: Management Of DI For Nonspecialists (With a Focus On Emergency Management In Hospitals)mentioning

confidence: 99%

Diagnosis and management of diabetes insipidus for the internist: an update

Winzeler

Refardt

2021

J Intern Med

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Section: Management Of DI For Nonspecialists (With a Focus On Emergency Management In Hospitals)mentioning

confidence: 99%

Diagnosis and management of diabetes insipidus for the internist: an update

Winzeler

Refardt

2021

J Intern Med

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“…This report was prompted by a study of patients hospitalized with central DI, which showed that desmopressin treatment had been missed or delayed in 88% of admissions, and that 35% of patients consequently developed dysnatraemia ( 21 ). This was attributed to a lack of understanding of the critical nature of desmopressin amongst clinical staff ( 22 ). In this context, it is very important that patients themselves are empowered with the knowledge of their condition and the essential difference between DI and diabetes mellitus, which caused confusion with serious consequences at the time of admission.…”

Section: Diabetes Insipidusmentioning

confidence: 99%

ENDOCRINOLOGY IN THE TIME OF COVID-19-2021 UPDATES: The management of diabetes insipidus and hyponatraemia

Hoorn

Sherlock

Thompson

et al. 2021

European Journal of Endocrinology

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COVID-19 has changed the nature of medical consultations, emphasizing virtual patient counseling, with relevance for patients with diabetes insipidus (DI) or hyponatremia. The main complication of desmopressin treatment in DI is dilutional hyponatraemia. Since plasma sodium monitoring is not always possible in times of COVID-19, we recommend to delay the desmopressin dose once a week until aquaresis occurs allowing excess retained water to be excreted. Patients should measure their body weight daily. Patients with DI admitted to the hospital with COVID-19 have a high risk for mortality due to volume depletion. Specialists must supervise fluid replacement and dosing of desmopressin. Patients after pituitary surgery should drink to thirst and measure their body weight daily to early recognize the development of postoperative SIAD. They should know hyponatraemia symptoms. Hyponatraemia in COVID-19 is common with a prevalence of 20 to 30% and is mostly due to SIAD or hypovolemia. It mirrors disease severity and is an early predictor for mortality. Hypernatraemia may also develop in COVID-19 patients, with a prevalence of 3-5%, especially in ICU, and derives from different multifactorial reasons, e.g. due to insensible water losses from pyrexia, increased respiration rate and use of diuretics. Hypernatraemic dehydration may contribute to the high risk of acute kidney injury in COVID-19. IV fluid replacement should be administered with caution in severe cases of COVID-19 because of the risk of pulmonary oedema.

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“…This report was prompted by a study of patients hospitalized with central DI, which showed that desmopressin treatment had been missed or delayed in 88% of admissions, and that 35% of patients consequently developed dysnatraemia 16 . This was attributed to a lack of understanding of the critical nature of desmopressin amongst clinical staff 17 . In this context it is very important that patients themselves are empowered with a knowledge of their condition and the essential difference between DI and diabetes mellitus which has caused confusion with serious consequences at the time of admission.…”

Section: Acute Infection With Suspected or Confirmed Covid-19mentioning

confidence: 99%

ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of diabetes insipidus and hyponatraemia

Christ‐Crain

Hoorn

Sherlock

et al. 2020

European Journal of Endocrinology

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Running title: DI and hypontraemia in times of COVID-19Word count abstract: 210 words Word count: 2'500 Number of tables: 2This manuscript is part of a commissioned series of urgent clinical guidance documents on the management of endocrine conditions in the time of COVID-19. This clinical guidance document underwent expedited open peer review by Joe Verbalis (USA), Jens Otto Jørgensen (Denmark), Stefan Bilz (Switzerland) and Georg Lindner (Switzerland).Disclaimer: Due to the emerging nature of the COVID-19 crisis this document is not based on extensive systematic review or meta-analysis, but on rapid expert consensus. The document should be considered as guidance only; it is not intended to determine an absolute standard of medical care. Healthcare staff need to consider individual circumstances when devising the management plan for a specific patient. AbstractCOVID-19 has changed the nature of medical consultations, emphasizing virtual patient counseling, with relevance for patients with diabetes insipidus (DI) or hyponatremia.The main complication of desmopressin treatment in DI is dilutional hyponatraemia. Since plasma sodium monitoring is not always possible in times of COVID-19, we recommend to

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Diabetes insipidus

Cited by 14 publications

References 8 publications

Diagnosis and management of diabetes insipidus for the internist: an update

Diagnosis and management of diabetes insipidus for the internist: an update

ENDOCRINOLOGY IN THE TIME OF COVID-19-2021 UPDATES: The management of diabetes insipidus and hyponatraemia

ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of diabetes insipidus and hyponatraemia

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