A case of idiopathic diabetes insipidus presented with bilateral hydroureteronephrosis and neurogenic bladder: A pediatric case report and literature review

  • Ozgur Haki Yuksel Fatih Sultan Mehmet Research and Training Hospital
  • Mithat Kivrak Mus State Hospital
  • Aytac Sahin Mus State Hospital
  • Serkan Akan Fatih Sultan Mehmet Research and Training Hospital
  • Ahmet Urkmez Fatih Sultan Mehmet Research and Training Hospital
  • Ayhan Verit Fatih Sultan Mehmet Research and Training Hospital
Keywords: bilateral non-obstructive hydronephrosis, neurogenic bladder, megaureter, diabetes insipidus, desmopressin

Abstract

Diabetes insipidus (DI) is a condition with heterogeneous clinical symptoms characterized by polyuria (urine output >4 mL/kg/hr) and polydipsia (water intake >2 L/m 2/d). In children, acquired nephrogenic DI (NDI) is more common than central DI (CDI). Diagnosis is based on the presence of high plasma osmolality and low urinary osmolality with significant water diuresis. A water deprivation test with vasopressin challenge, though has limitations, is done to differentiate NDI from CDI and diagnose their incomplete forms. Neonates and young infants are better managed with hydration therapy alone. Older children with CDI are treated with desmopressin (1-deamino-8-D-arginine vasopressin, dDAVP). Its oral form is safe, highly effective and has dosing flexibility. We report a case of an 8-year-old male patient with CDI with severe bilateral non-obstructive hydronephrosis and megaureter. Dramatic clinical and radiological responses to dDAVP treatment were achieved and therapy reduced urine volume and led to marked radiological improvement in hydronephrosis.
Published
2015-11-04
How to Cite
Yuksel, O. H., Kivrak, M., Sahin, A., Akan, S., Urkmez, A., & Verit, A. (2015). A case of idiopathic diabetes insipidus presented with bilateral hydroureteronephrosis and neurogenic bladder: A pediatric case report and literature review. Canadian Urological Association Journal, 9(11-12), E817-20. https://doi.org/10.5489/cuaj.3092
Section
Case Report