Normal Hemodynamic and Coagulation Responses to 1 -Deamino-8-D-Arginine Vasopressin in a Case of Lithium-Induced Nephrogenic Diabetes insipidus
- 1 January 1992
- journal article
- case report
- Published by S. Karger AG in Hormone Research
- Vol. 37 (4-5) , 190-195
- https://doi.org/10.1159/000182308
Abstract
The effect of 1-deamino-8-D-arginine vasopressin (DDAVP) on mean arterial pressure, pulse rate (PR), plasma renin activity (PRA), plasma factor VIIIC and von Willebrand factor were studied in a case of persistent lithium-induced nephrogenic diabetes insipidus (LINDI). 20% decrease in MAP, 22% increase in PR, 100% in PRA, and release of coagulation factors (2- to 3-fold) were noticed after infusion of 0.3 µg/kg DDAVP. Urinary prostaglandin (PG) E2 were enhanced. The treatment of this LINDI by PG synthesis inhibitor (PSI) combined with a low osmotic diet (LOD) led to a 51 % fall in urine volume, 57 % in free water clearance and 75 % in sodium clearance. Urinary osmolality rose by 42% but remained low, probably in part because of the LOD. Urinary PGE2 was about one fifth of the initial high value. The results argue for (1) an end-organ resistance to DDAVP confined to the kidneys in LINDI and (2) an effectiveness of indomethacin combined with an LOD.Keywords
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