title: Massive postoperative polyuria following total gastrectomy for gastric cancer.
abstract: Massive postoperative polyuria is rare, except in neurosurgery patients. Here we report excessive polyuria in a 59-year-old woman following total gastrectomy for advanced gastric cancer. The etiology of the patient's polyuria was unknown. Urine output was measured hourly and replaced with Ringer's lactate solution at 80% of measured volume. The rate of urine output during 9 postoperative days ranged from 900 to 2700 ml.h(-1). Several administrations of an antidiuretic hormone (ADH) analogue were ineffective in reducing urine output, suggesting a possible relationship of the massive polyuria to nephrogenic diabetes insipidus. Following oral administration of a thiazide diuretic, known to exert an antidiuretic action in nephrogenic diabetes insipidus, urine output was dramatically reduced. We conclude that this case of massive polyuria probably resulted from postoperative nephrogenic diabetes insipidus.
authors.affiliation: Department of Surgery, Kanto Rosai Hospital, Kawasaki, Japan.
authors.forename: Hiroharu
authors.initials: H
authors.lastname: Yamashita
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ishimaru
authors.forename: Hironori
authors.initials: H
authors.lastname: Yamaguchi
authors.forename: Haruo
authors.initials: H
authors.lastname: Yamauchi
authors.forename: Arishige
authors.initials: A
authors.lastname: Sugiura
authors.forename: Joji
authors.initials: J
authors.lastname: Kitayama
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Nagawa
mesh_terms: D051399:Aquaporin 2 / Q000502:physiology; D000242:Cyclic AMP / Q000502:physiology; D003919:Diabetes Insipidus / Q000150:complications; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D011141:Polyuria / Q000188:drug therapy / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*; D049993:Sodium Chloride Symporter Inhibitors / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000601:surgery*
chemical_list: C496023:AQP2 protein, human; D051399:Aquaporin 2; D049993:Sodium Chloride Symporter Inhibitors; D000242:Cyclic AMP