Resolution of Diabetes Insipidus After Pyeloplasty: A Case Report and Review of the Literature

Carpenter, Christina P.; Rawson, Ashley; Giel, Dana W.

doi:10.1016/j.urology.2018.02.017

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…It is worth noting that hydronephrosis and/ or deterioration of renal function may recur a few years after spontaneous resolution of hydronephrosis, and it is usually accompanied by symptoms, such as abdominal pain, nausea, vomiting, and hematuria (16). Carpenter et al (8) reported that patients should undergo continuous careful monitoring postoperatively if symptoms persist, such as polydipsia and polyuria. The clinical/surgical approach has changed a lot and plays a positive role in the preservation of renal function.…”

Section: Discussionmentioning

confidence: 99%

“…However, there are no studies or guidelines that indicate the specific follow-up intervals and surgical indications for mild hydronephrosis if predisposing risk factors persist. DI causes non-obstructive hydronephrosis (8); however, to the best of our knowledge, no studies have shown whether DI can cause or aggravate obstructive hydronephrosis. This article describes a case of asymptomatic obstructive hydronephrosis that was aggravated by DI.…”

Section: Introductionmentioning

confidence: 90%

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Asymptomatic obstructive hydronephrosis associated with diabetes insipidus: a case report and review

Sun¹,

Zhao²,

Zhu³

et al. 2021

Transl Pediatr

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The treatment of asymptomatic hydronephrosis due to ureteropelvic junction obstruction (UPJO), as well as the timing and indications for surgical intervention, remain controversial. Diabetes insipidus (DI) is a rare disease in infants that is known to cause non-obstructive hydronephrosis, while its association with obstructive hydronephrosis has not been reported. Some studies have found that increased water intake is a predisposing risk factor of developing hydronephrosis. However, there are no studies or guidelines that indicate the specific follow-up intervals and surgical indications for mild hydronephrosis if predisposing risk factors persist. A 46-month-old boy was admitted to our Urology Department with a history of Society of Fetal Urology (SFU) Grade 2 prenatal left hydronephrosis, which was stable at SFU Grade 1-2 at regular postnatal follow-ups. The patient developed polydipsia and polyuria three months prior to admission, then he was considered as primary polydipsia by endocrinology and was treated with fluid restriction while the examination was negative. Renal ultrasound at follow-up demonstrated severe left hydronephrosis with an anterior-posterior diameter (APD) of 6.25 cm three months after symptom onset. Diuretic renography (DR) revealed a renal function of 13.7% with a glomerular filtration rate (GFR) of 11.25 mL/min. The patient was otherwise asymptomatic without any abdominal pain or vomiting. He underwent left pyelostomy immediately as well as laparoscopic left dismembered ureteropelvioplasty after three months, and a diagnosis of UPJO was confirmed. The patient had an uncomplicated postoperative recovery and the result of follow-up renal ultrasound was stable. However, the symptoms of polydipsia and polyuria did not improve significantly. He underwent pituitary magnetic resonance imaging (MRI) and pathological examination, the results of which were consistent with central DI caused by Langerhans cell hyperplasia four months postoperatively. This case indicates the need to pay attention to children with mild hydronephrosis undergoing regular observation and conservative treatment, as a sudden aggravation of the hydronephrosis and a rapid decline of renal function may occur if DI persists.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 90%

Asymptomatic obstructive hydronephrosis associated with diabetes insipidus: a case report and review

Sun¹,

Zhao²,

Zhu³

et al. 2021

Transl Pediatr

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Congenital nephrogenic diabetes insipidus accompanied with central nephrogenic diabetes secondary to pituitary surgery -a case report

et al. 2021

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Background Diabetes insipidus (DI) can be a common cause of polydipsia and polyuria. Here, we present a case of congenital nephrogenic diabetes insipidus (CNDI) accompanied with central diabetes insipidus (CDI) secondary to pituitary surgery. Case presentation A 24-year-old Chinese woman came to our hospital with the complaints of polydipsia and polyuria for 6 months. Six months ago, she was detected with pituitary apoplexy, and thereby getting pituitary surgery. However, the water deprivation test demonstrated no significant changes in urine volume and urine gravity in response to fluid depression or AVP administration. In addition, the genetic results confirmed a heterozygous mutation in arginine vasopressin receptor type 2 (AVPR2) genes. Conclusions She was considered with CNDI as well as acquired CDI secondary to pituitary surgery. She was given with hydrochlorothiazide (HCTZ) 25 mg twice a day as well as desmopressin (DDAVP, Minirin) 0.1 mg three times a day. There is no recurrence of polyuria or polydipsia observed for more than 6 months. It can be hard to consider AVPR2 mutation in female carriers, especially in those with subtle clinical presentation. Hence, direct detection of DNA sequencing with AVPR2 is a convenient and accurate method in CNDI diagnosis.

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Resolution of Diabetes Insipidus After Pyeloplasty: A Case Report and Review of the Literature

Cited by 2 publications

References 12 publications

Asymptomatic obstructive hydronephrosis associated with diabetes insipidus: a case report and review

Asymptomatic obstructive hydronephrosis associated with diabetes insipidus: a case report and review

Congenital nephrogenic diabetes insipidus accompanied with central nephrogenic diabetes secondary to pituitary surgery -a case report

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