title: Renal compensatory adaptation for water handling in a patient with adipsic diabetes insipidus after clipping of a ruptured aneurysm of the anterior communicating artery .
abstract: A 38-year-old Japanese man who had undergone clipping surgery for a ruptured aneurysm of the anterior communicating artery 2 days prior, suddenly developed refractory hypernatremia (serum sodium (Na) 156 - 162 mmol/L). Symptoms included low plasma vasopressin, fluctuating urine osmolality (120 - 710 mOsm/kg) and lack of thirst, all suggesting adipsic diabetes insipidus (ADI). Hypernatremia was corrected by scheduled water intake with desmopressin administration. During 1-year follow-up after the surgery, his serum Na level normalized despite the suspension of desmopressin, but neither thirst nor osmolality-dependent vasopressin release recovered. Meanwhile, his urine osmolality shifted to a constant high level. The present case suggests that renal compensatory adaptation, apparently independent of the circulating vasopressin level, plays a major role in water handling in longitudinal ADI. .
authors.forename: Eri
authors.initials: E
authors.lastname: Imai
authors.forename: Shuzo
authors.initials: S
authors.lastname: Kaneko
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tsukamoto
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D017542:Aneurysm, Ruptured / Q000503:physiopathology*; D001834:Body Water / Q000378:metabolism*; D003919:Diabetes Insipidus / Q000503:physiopathology*; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications*; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D014667:Vasopressins / Q000502:physiology
chemical_list: D014667:Vasopressins