Federal clinical guidelines on diagnosis and treatment of diabetes insipidus in adults

Dedov, Ivan I.; Melnichenko, G. A.; Pigarova, Ekaterina; Dzeranova, Larisa; Rozhinskaya, Ludmila; Przhiyalkovskaya, Elena; Belaya, Zhanna; Grigoriev, Andrey; Воронцов, А. В.; Lutsenko, Alexander; Astafyeva, Ludmila

doi:10.14341/omet2018256-71

Cited by 5 publications

(2 citation statements)

References 24 publications

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“…Центральный несахарный диабет (НД; синонимы: нейрогенный несахарный диабет, гипоталамический несахарный диабет, гипофизарный несахарный диабет, несахарное мочеизнурение) -заболевание, характеризующееся неспособностью почек реабсорбировать воду и концентрировать мочу, имеющее в своей основе дефект синтеза или секреции вазопрессина и проявляющееся выраженной жаждой и экскрецией большого количества разведенной мочи [1,2]. При несахарном диабете у больных вырабатывается большой объем мочи с низким удельным весом.…”

Section: Introductionunclassified

“…Четкое деление центрального НД на функциональный и органический в клинической практике осуществить трудно. Идиопатическую форму НД можно подозревать в тех случаях, когда отсутствуют признаки поражения гипоталамуса и не удается установить причину заболевания [2,4]. Обычно эта форма болезни наследуется по аутосомно-доминантному типу.…”

Section: Introductionunclassified

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Распространенность Различных Форм Несахарного Диабета И Его Осложнений В Республике Узбекистан

Urmanova¹,

Khamraeva²

2021

Mìžnarodnij endokrinologìčnij žurnal

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Background. Central diabetes insipidus is characterized by the inability of the kidneys to reabsorb water and concentrate urine, which is due to the defect in the synthesis or secretion of vasopressin and is manifested by severe thirst and excretion of large amounts of diluted urine. The purpose of the study is to assess the prevalence of various forms of diabetes insipidus and its complications, the quality of diagnosis and treatment according to the data of regional endocrinological dispensaries of the Republic of Uzbekistan. Materials and methods. The study used data from the register of patients with diabetes insipidus registered in regional endocrinological centers in all regions of the Republic of Uzbekistan and the Republic of Karakalpakstan in 2018, as well as our own observations. It was found that by the end of 2018, 1,237 children and adolescents with diabetes insipidus were registered in the Republic of Uzbekistan and the Republic of Karakalpakstan. Of these, data of 397 patients with diabetes insipidus were analyzed. Their average age was 5.6 ± 2 years. Results. The idiopathic form of diabetes insipidus was observed predominantly — in 214 individuals (55.8 %), the second most common form was central diabetes insipidus — 129 patients (40.9 %), while the renal and hereditary forms of the disease were less common — 26 (3.3 %) and 3 (0.2 %), respectively. The majority of patients (48.9 %) did not associate the onset of the disease with any factor. However, in 20.4 % of individuals, diabetes insipidus developed after a skull injury. In 4.8 % of patients, the cause of the disease was tumors of the hypothalamic-pituitary region, and in 14.5 % — neuroviral infection. Hereditary predisposition was observed in 0.4 % of patients. Conclusions. In the regions of the Republic of Uzbekistan and the Republic of Karakalpakstan, two forms of diabetes insipidus were most common: idiopathic — 214 (55.8 %) and central — 129 cases (40.9 %). Most of the patients — 85 children (22.9%) — were aged 0 to 9 years. The average age of ill children and adolescents was 7.6 years. The disease was more often detected in males (51.1 %).

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Section: Introductionunclassified

Распространенность Различных Форм Несахарного Диабета И Его Осложнений В Республике Узбекистан

Urmanova¹,

Khamraeva²

2021

Mìžnarodnij endokrinologìčnij žurnal

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The 3% hypertonic saline infusion test for the differential diagnosis of diabetes insipidus and primary polydipsia: assessment of diagnostic accuracy

Katamadze,

Pigarova,

Dzeranova

et al. 2024

Obes. metabol.

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AIM: assessment of the diagnostic accuracy of a 3% hypertonic saline infusion test in relation to a set of clinical and laboratory data (including a water deprivation test and MRI data) for differential diagnoses of diabetes insipidus (DI) and primary polydipsia (PP).METHODS: An interventional cross-sectional study was carried out at Endocrinology Research Centre From September 2021 to September 2023 ninety patients with polyuria-polydipsia syndrome were included. In order to assess the diagnostic characteristics, all the subjects underwent two tests with osmotic stimulation: a 3% hypertonic saline infusion test and a water deprivation test. Adverse events were assessed.RESULTS: Based on the results of clinical, anamnestic, laboratory and instrumental data, and the results of a water deprivation test, a final diagnosis of DI was made in 48 (53%) patients and PP in 42 (47%) patients. The agreement between the two samples is significant — Kappa = 0.823, 95% CI (0.707, 0.939). The operational parameters of the 3% hypertonic saline infusion test are: sensitivity 98% (95% CI: 89%; 100%); specificity 98% (95% CI: 87%; 100%), positive and negative predictive values 98% (95% CI: 89%–100%) and 98% (95% CI: 87%–100%). Respectively. Chills occurred significantly more often (31% vs. 12%), and dizziness and headache were more pronounced during the 3% hypertonic saline infusion test. The median duration of the water deprivation test in patients was 11 hours, and median duration of 3% hypertonic saline infusion test was 1.5 hour (P<0.001).CONCLUSION: The 3% hypertonic saline infusion test has a high overall diagnostic accuracy 98%; 95% CI 92% to 100%)) in relation to the classical set of clinical, laboratory and instrumental data of patients (including a water deprivation test), However, it is important the advantage of the latter is its short duration and, as a consequence, better tolerability and probably better compliance, while no significant differences in adverse events frequencies during the tests were identified.

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Family form of nephrogenic Х-linked diabetes insipidus

Klepalova

Pushkareva

Iziurova

et al. 2022

Probl Endokrinol (Mosk)

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There is a global trend towards an increase in the prevalence of diabetes insipidus. Symptoms of nephrogenic diabetes insipidus with X-linked inheritance appear in men, in women with heterozygous mutations, are characterized by an isolated symptom complex of polyuria, polydipsia, hypostenuria. In children, more often than in adults, with fluid restriction, a clinic of water-deficient dehydration develops with hypernatremia, hyperthermia, and plasma hyperosmolality. This manuscript presents a case of Nephrogenic diabetes insipidus, X-linked familial form in male patients.At the same time, in the family along the female line, the mother and grandmother also had an increased need for water, the use of minirin was ineffective. In the older brother and younger brother, clinical manifestations of diabetes insipidus in the form of severe thirst and polyuria were noted from infancy, after the examination, the diagnosis was made — diabetes insipidus and desmopressin was prescribed.Due to the lack of effect from the use of desmopressin, the analysis of exons and adjacent sections of the introns of the AQP2 and AVPR2 genes was carried out by PCR and subsequent direct sequencing. No mutations were found in the AQP2 gene. The hemizygous substitution S315I was found in the AVPR2 gene. The familial form X was confirmed — linked nephrogenic diabetes insipidus. A hypothiazide was recommended, against the background of constant intake of which only a slight positive trend is observed.

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Federal clinical guidelines on diagnosis and treatment of diabetes insipidus in adults

Cited by 5 publications

References 24 publications

Распространенность Различных Форм Несахарного Диабета И Его Осложнений В Республике Узбекистан

Распространенность Различных Форм Несахарного Диабета И Его Осложнений В Республике Узбекистан

The 3% hypertonic saline infusion test for the differential diagnosis of diabetes insipidus and primary polydipsia: assessment of diagnostic accuracy

Family form of nephrogenic Х-linked diabetes insipidus

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