期刊
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
卷 107, 期 10, 页码 2701-2715出版社
ENDOCRINE SOC
DOI: 10.1210/clinem/dgac381
关键词
diabetes insipidus; hypernatremia; hyponatremia; adipsia; dDAVP
资金
- Health Research Board (HRB)
- Wellcome Trust [203930/B/16/Z]
- Royal College of Surgeons in Ireland (RCSI)/Beacon Hospital Strategic Academic Recruitment (StAR) program
- Irish Endocrine Society Clinical Science Award
- Wellcome Trust [203930/B/16/Z] Funding Source: Wellcome Trust
This article primarily introduces the diagnosis and treatment of central diabetes insipidus, as well as the related physiological disturbances. Recent developments in diagnostic techniques have improved the accuracy and acceptability of the diagnostic approach. The article also discusses the management of fluid intake and pharmacological replacement of AVP, as well as the management of related clinical syndromes.
Central diabetes insipidus (CDI) is a clinical syndrome which results from loss or impaired function of vasopressinergic neurons in the hypothalamus/posterior pituitary, resulting in impaired synthesis and/or secretion of arginine vasopressin (AVP). AVP deficiency leads to the inability to concentrate urine and excessive renal water losses, resulting in a clinical syndrome of hypotonic polyuria with compensatory thirst. CDI is caused by diverse etiologies, although it typically develops due to neoplastic, traumatic, or autoimmune destruction of AVP-synthesizing/secreting neurons. This review focuses on the diagnosis and management of CDI, providing insights into the physiological disturbances underpinning the syndrome. Recent developments in diagnostic techniques, particularly the development of the copeptin assay, have improved accuracy and acceptability of the diagnostic approach to the hypotonic polyuria syndrome. We discuss the management of CDI with particular emphasis on management of fluid intake and pharmacological replacement of AVP. Specific clinical syndromes such as adipsic diabetes insipidus and diabetes insipidus in pregnancy as well as management of the perioperative patient with diabetes insipidus are also discussed.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据