title: Bendamustine-Induced Nephrogenic Diabetes Insipidus in a Patient With AL Amyloidosis.
abstract: Nephrogenic diabetes insipidus is a condition characterized by polyuria with dilute urine due to the inability of the principal cells of the renal collecting ducts to respond to antidiuretic hormone and concentrate urine. Nephrogenic diabetes insipidus can be drug induced, and several chemotherapeutic agents have been reported to cause it. Bendamustine is a traditional chemotherapeutic agent being studied for treatment for relapsed systemic AL amyloidosis. We report a case of a 59-year-old man with AL amyloidosis who developed partial nephrogenic diabetes insipidus after receiving bendamustine for treatment of AL amyloidosis. The nephrogenic diabetes insipidus responded well to sodium restriction, hydrochlorothiazide, and desmopressin treatment, allowing the patient to receive subsequent bendamustine cycles without polyuria. Nephrogenic diabetes insipidus resolved shortly after completion of bendamustine therapy.
authors: Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA.
authors: Nsabimana A
authors: NA
authors: Uwumugambi
authors: Amyloidosis Center, Section of Hematology and Oncology, Boston University School of Medicine and Boston Medical Center, Boston, MA.
authors: Vaishali
authors: V
authors: Sanchorawala
authors: Amyloidosis Center, Section of Hematology and Oncology, Boston University School of Medicine and Boston Medical Center, Boston, MA.
authors: Anthony C
authors: AC
authors: Shelton
authors: Section of Renal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA.
authors: Lauren
authors: L
authors: Stern
authors: Section of Renal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA. Electronic address: craig.gordon@bmc.org.
authors: Craig E
authors: CE
authors: Gordon
mesh_terms: D000686:Amyloidosis / Q000188:drug therapy* / Q000276:immunology; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects* / Q000627:therapeutic use; D000069461:Bendamustine Hydrochloride / Q000009:adverse effects* / Q000627:therapeutic use; D018500:Diabetes Insipidus, Nephrogenic / Q000139:chemically induced*; D006801:Humans; D007147:Immunoglobulin Light Chains; D008297:Male; D008875:Middle Aged
chemical_list: D018906:Antineoplastic Agents, Alkylating; D007147:Immunoglobulin Light Chains; D000069461:Bendamustine Hydrochloride
keywords: DDAVP; Renal AL amyloidosis; bendamustine; case report; chemotherapy; desmopressin; drug-induced NDI; low urine osmolality; nephrogenic diabetes insipidus (NDI); nephrotoxicity; partial NDI; polyuria; water restriction test