CHLORPROPAMIDE TREATMENT OF DIABETES INSIPIDUS IN CHILDREN

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Abstract
Oral chlorpropamide therapy was assessed in 10 children with pitressin-sensitive diabetes insipidus. A significant increase in urine osmolality occurred in eight of nine children studied pre- and post-treatment, with concomitant reduction in urine output and free water clearance. Mean 24-hour urine output during control periods was 5,410 ml (range, 3,000 to 12,000 ml). On chlorpropamide therapy, mean output fell to 2,790 ml (range, 1,200 to 5,500 ml). Complete withdrawal of intramuscular pitressin therapy was possible in 9 of the 10 patients, and these children have now been maintained on chlorpropamide alone for periods of up to 12 months. The principal complication of therapy was symptomatic hypoglycemia, which occurred in half the patients studied during the early phases of treatment. However, it was possible to eliminate this problem by reducing the dose of chlorpropamide while retaining sufficient antidiuretic effect to permit reasonable control of water balance. Current evidence suggests that the antidiuretic action of chlorpropamide may be due to enhancement of the sensitivity of the renal tubule to small amounts of vasopressin. For many, though not all, children with pitressin-sensitive diabetes insipidus, chlorpropamide is a fairly effective therapeutic agent. It is readily accepted by the patients in preference to frequent intramuscular injections of pitressin.

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