Indomethacin in the treatment of lithium-induced nephrogenic diabetes insipidus.
Nephrogenic diabetes insipidus (NDI) is a frequent complication in patients receiving long-term lithium therapy. Both thiazide diuretics and amiloride may reduce the polyuria, but the use of each is associated with problems. We report the results of a clinical trial using the nonsteroidal anti-inflammatory drug indomethacin to treat a patient with well-documented lithium-induced NDI that persisted following cessation of lithium treatment. The administration of a single dose of indomethacin resulted in a dramatic decrease in urine volume and increase in urine osmolality that persisted for several hours, and was independent of renal hemodynamic changes. Subsequently, the patient experienced a sustained, favorable effect on her polyuria during long-term (3 months) indomethacin therapy without a deleterious effect on her renal function. Indomethacin may be a useful therapeutic tool for the amelioration of lithium-induced NDI.
Allen
H M
HM
Department of Medicine, University of Oklahoma School of Medicine, Oklahoma City 73104.
Jackson
R L
RL
Winchester
M D
MD
Deck
L V
LV
Allon
M
M
D000328:Adult; D003919:Diabetes Insipidus / Q000139:chemically induced / Q000188:drug therapy* / Q000652:urine; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D007674:Kidney Diseases / Q000139:chemically induced / Q000188:drug therapy; D008094:Lithium / Q000009:adverse effects*; D011141:Polyuria / Q000188:drug therapy
D008094:Lithium; D007213:Indomethacin