title: Adipsia increases risk of death in patients with central diabetes insipidus.
abstract: Central diabetes insipidus (CDI) is caused by deficiency of arginine vasopressin, an antidiuretic hormone. Patients with CDI manifest polyuria which is usually compensated for by increases in water intake. However, some patients are not able to sense thirst due to the destruction of osmoreceptors in the hypothalamus. These adipsic CDI patients are easily dehydrated and the consequent dehydration could be life-threatening. The objective of this study was to investigate the prognosis of adipsic CDI patients. We have reviewed 149 patients with CDI in three hospitals using databases of the electronic medical recording systems, and examined whether adipsia could affect the morbidity and mortality in CDI patients with multivariable analyses. Twenty-three patients with CDI were adipsic while the remaining 126 patients were non-adipsic. The multivariate analyses showed that the incidence of serious infections which required hospitalization was significantly higher in the adipsic CDI patients compared to that in non-adipsic CDI patients (p <0.001). A total of 6 patients with CDI died during the follow-up (median duration; 60 months, range 1 to 132 months). Four of them were adipsic, three of whom died of infection. The statistical analyses revealed that the risk of death in adipsic CDI patients was significantly higher than in non-adipsic patients (p =0.007). It is thus suggested that adipsic CDI patients were susceptible to serious infections which could be the causes of death.
authors.affiliation: Department of Endocrinology and Diabetes, Field of Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Arima
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Wakabayashi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Nagatani
authors.forename: Masazumi
authors.initials: M
authors.lastname: Fujii
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hirakawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Murase
authors.forename: Yuko
authors.initials: Y
authors.lastname: Yambe
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Yamada
authors.forename: Fumiko
authors.initials: F
authors.lastname: Yamakawa
authors.forename: Ikuo
authors.initials: I
authors.lastname: Yamamori
authors.forename: Masako
authors.initials: M
authors.lastname: Yamauchi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Oiso
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003681:Dehydration / Q000209:etiology* / Q000401:mortality; D020790:Diabetes Insipidus, Neurogenic / Q000150:complications / Q000401:mortality*; D005260:Female; D006801:Humans; D007239:Infections / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D013894:Thirst