Open AccessManagement of Diabetes Insipidus following Surgery for Pituitary and Suprasellar Tumors
Author(s) -
Mussa Almalki,
Maswood M Ahmad,
Imad Brema,
Mohammed Almehthel,
Khaled M. Aldahmani,
Moeber Mahzari,
Salem A Beshyah
Publication year - 2021
Publication title -
sultan qaboos university medical journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.258
H-Index - 27
eISSN - 2075-0528
pISSN - 2075-051X
DOI - 10.18295/squmj.4.2021.010
Subject(s) - medicine , diabetes insipidus , polyuria , polydipsia , desmopressin , craniopharyngioma , hyponatremia , transsphenoidal surgery , pituitary adenoma , pituitary tumors , surgery , pituitary neoplasm , vasopressin , pituitary gland , pediatrics , adenoma , diabetes mellitus , endocrinology , hormone
Central diabetes insipidus (CDI) is a common complication after pituitary surgery. However, it is most frequently transient. It is defined by the excretion of an abnormally large volume of dilute urine with increasing serum osmolality. The reported incidence of CDI after pituitary surgery ranges from 0-90%. Large tumour size, gross total resection and intraoperative cerebrospinal fluid leak usually pose an increased risk of CDI as observed with craniopharyngioma and Rathke's cleft cysts. CDI can be associated with high morbidity and mortality if not promptly recognised and treated on time. It is also essential to rule out other causes of postoperative polyuria to avoid unnecessary pharmacotherapy and iatrogenic hyponatremia. Once the diagnosis of CDI is established, close monitoring is required to evaluate the response to treatment and to determine whether the CDI is transient or permanent. This review outlines the evaluation and management of patients with CDI following pituitary and suprasellar tumour surgery to help recognise the diagnosis, consider the differential diagnosis, initiate therapeutic interventions and guide monitoring and long-term management.