Nephrogenic diabetes insipidus: treat with caution.
Current therapy for congenital nephrogenic diabetes insipidus consists of appropriate water intake coupled with decreased urine output obtained by means of a low-sodium diet and a combination of thiazide diuretics with renal prostaglandins inhibitors or amiloride. We report a case of congenital nephrogenic diabetes insipidus that was complicated by paradoxical water intoxication secondary to liberal water intake and the initiation of hydrochlorothiazide and indomethacin combination therapy. This report emphasizes the importance of evaluating the water balance and of a quick response with strict protocols following the initiation of indomethacin and thiazide diuretics in nephrogenic diabetes insipidus.
Pediatric Intensive Care Unit and Department of Pediatrics, Centre Hospitalier du Mans, Le Mans, France. tboussemart@ch-lemans.fr
Thierry
T
Boussemart
Jacqueline
J
Nsota
Dominique
D
Martin-Coignard
Gérard
G
Champion
D000584:Amiloride / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D018500:Diabetes Insipidus, Nephrogenic / Q000151:congenital / Q000235:genetics / Q000628:therapy*; D004039:Diet, Sodium-Restricted; D004232:Diuretics / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D040181:Genetic Diseases, X-Linked; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D007213:Indomethacin / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D009154:Mutation; D017483:Receptors, Vasopressin / Q000235:genetics; D016896:Treatment Outcome; D014554:Urination / Q000187:drug effects; D014869:Water Intoxication / Q000188:drug therapy / Q000209:etiology
D016861:Cyclooxygenase Inhibitors; D004232:Diuretics; D017483:Receptors, Vasopressin; D006852:Hydrochlorothiazide; D000584:Amiloride; D007213:Indomethacin