Water-balance hormones during long-term follow-up of oral dDAVP treatment in diabetes insipidus.
The aim of the present study was to investigate the hormonal control of water-balance in children with diabetes insipidus and to assess safety and efficacy of long-term treatment with oral dDAVP. Plasma atrial natriuretic peptide, plasma renin activity, aldosterone, plasma and urinary cyclic 3'5'-guanosine monophosphate and urinary prostaglandin E2 were measured in eight patients (aged 3-21 y) with central diabetes insipidus. At baseline, 12 h after the last dDAVP dose, patients had hypotonic polyuria but normal plasma sodium concentrations and plasma osmolality relative to a control group. The mean plasma atrial natriuretic peptide concentration in patients (26.2 +/- 2.6 pg/ml) tended to be lower than in controls (36.5 +/- 8.2 pg/ml, mean +/- SEM), although the difference was not significant. Plasma cyclic 3'5' guanosine monophosphate was higher in controls (6.0 +/- 0.6 pmol/ml, mean +/- SEM) than in patients (3.8 +/- 0.3 pmol/ml). Aldosterone, plasma renin activity, urinary cyclic guanosine monophosphate and urinary prostaglandin E2 were similar in the two groups. During 3 h following dDAVP administration, atrial natriuretic peptide levels did not change in patients but decreased significantly in controls to 23.0 +/- 4.0 pg/ml. No adverse reactions, or circulating antibodies against dDAVP, were observed after 3.5 years of oral dDAVP treatment. The average oral dDAVP dosage was similar after 1 and 3.5 years of treatment (906 +/- 406 micrograms/24 h, mean +/- SD). Water-balance is not detectably different from normal in correctly treated diabetes insipidus patients in terms of plasma atrial natriuretic peptide, plasma renin activity and aldosterone levels. Long-term oral dDAVP treatment is safe and efficacious.
Fjellestad-Paulsen
A
A
Department of Paediatric Endocrinology and Diabetes, Hôpital des Enfants Malades, Paris, France.
Laborde
K
K
Kindermans
C
C
Czernichow
P
P
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000450:Aldosterone / Q000097:blood; D009320:Atrial Natriuretic Factor / Q000097:blood; D002648:Child; D002675:Child, Preschool; D006152:Cyclic GMP / Q000378:metabolism; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage*; D003919:Diabetes Insipidus / Q000188:drug therapy* / Q000378:metabolism; D015232:Dinoprostone / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012083:Renin / Q000097:blood; D014882:Water-Electrolyte Balance
D000450:Aldosterone; D009320:Atrial Natriuretic Factor; D012083:Renin; D003894:Deamino Arginine Vasopressin; D006152:Cyclic GMP; D015232:Dinoprostone