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Water‐balance hormones during long‐term follow‐up of oral dDAVP treatment in diabetes insipidus
Author(s) -
FjellestadPaulsen Anne,
Laborde Kathleen,
Kindermans Catherine,
Czernichow Paul
Publication year - 1993
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1993.tb12552.x
Subject(s) - medicine , diabetes insipidus , hormone , endocrinology , diabetes mellitus , balance (ability) , term (time) , physical therapy , physics , quantum mechanics
The aim of the present study was to investigate the hormonal control of water‐balance in children with diabetes insipidus and to assess safety and efficacy of long‐term treatment with oral dDAVP. Plasma atrial natriuretic peptide, plasma renin activity, aldosterone, plasma and urinary cyclic 3'5′‐guanosine monophosphate and urinary prostaglandin E z were measured in eight patients (aged 3–21 y) with central diabetes insipidus. At baseline, 12 h after the last dDAVP dose, patients had hypotonic polyuria but normal plasma sodium concentrations and plasma osmolality relative to a control group. The mean plasma atrial natriuretic peptide concentration in patients (26.2 ± 2.6 pg/ml) tended to be lower than in controls (36.5 ± 8.2 pg/ml. mean ± SEM), although the difference was not significant. Plasma cyclic 3′5′ guanosine monophosphate was higher in controls (6.0 ± 0.6 pmol/ml, mean ± SEM) than in patients (3.8 ± 0.3 pmol/ml). Aldosterone, plasma renin activity, urinary cyclic guanosine monophosphate and urinary prostaglandin E 2 were similar in the two groups. During 3 h following dDAVP administration, atrial natriuretic peptide levels did not change in patients but decreased significantly in controls to 23.0 ± 4.0 pg/ml. No adverse reactions, or circulating antibodies against dDAVP, were observed after 3.5 years of oral dDAVP treatment. The average oral dDAVP dosage was similar after 1 and 3.5 years of treatment (906 ± 406 μ g/24 h, mean ± SD). Water‐balance is not detectably different from normal in correctly treated diabetes insipidus patients in terms of plasma atrial natriuretic peptide, plasma renin activity and aldosterone levels. Long‐term oral dDAVP treatment is safe and efficacious.