Abstract

Polyuria in post-kidney transplant (KT) patients is a common condition generally attributed to delayed tubular function, fluid administration, and solute diuresis. Since excessive water intake post-KT physiologically suppresses arginine vasopressin (AVP) secretion, central diabetes insipidus (CDI) caused by deficient primary AVP release can be overlooked. Although DDAVP (desmopressin) – a selective AVP V2 receptor agonist – has been used to treat massive polyuria, CDI rarely progresses to kidney injury due to the preservation of fluid balance by thirst-dependent osmoregulation. Administration of DDAVP in post-KT recipients with mild polyuria and subclinical CDI is difficult to assess, and whether long-term use of DDAVP is beneficial for the transplanted kidney has not been established. We present the case of a 36-year-old Japanese female who was diagnosed with subclinical/partial CDI post KT. CDI was caused by a sequela of suprasellar germinoma. Graft function gradually declined without evidence of hypovolemia or hypernatremia, and a kidney biopsy revealed advanced ischemic kidney injury. Although daily oral DDAVP administration did not increase extracellular fluid volume, treatment resulted in a gradual improvement of graft function, and a follow-up transplanted kidney biopsy indicated substantial recovery.


Author Details

Authors

• Shuzo Kaneko¹
• Joichi Usui¹
• Kunio Kawanishi²
• Ryota Ishii¹
• Kazuhiro Takahashi³
• Hiroaki Suzuki⁴
• Chie Saito¹
• Tatsuya Oda³
• Michio Nagata²
• Kunihiro Yamagata¹

Departments

• ¹ Nephrology, Faculty of Medicine,
• ² Kidney, Vascular Pathology, Faculty of Medicine,
• ³ Gastroenterological, Hepatobiliary Surgery, Organ Transplantation,
• ⁴ Endocrinology, Metabolism, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan

Address


Shuzo Kaneko, MD, PhD
, Nephrology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan

Email: sz-kaneko@
md.tsukuba.ac.jp

---

Log in for Subscribers

Citation