J Korean Endocr Soc.  2009 Jun;24(2):144-147. 10.3803/jkes.2009.24.2.144.

Central Diabetes Insipidus Surmised as from Post-obstructive Diuresis after Decompression Treatment for Neurogenic Bladder

• Lee KW
• Yang CW
• Lim DJ
• Kwon HS
• Kang MJ
• Kim ES
• Yoon KH
• Son HY
• Cha BY

• KMID: 1468511
• DOI: http://doi.org/10.3803/jkes.2009.24.2.144

Abstract

Post-obstructive diuresis after treatment for neurogenic bladder-induced obstructive kidney disease is a common symptom. As polyuria may develop in many other conditions as well, the present case is about a patient with a chief complaint of polyuria accompanied by nocturia, that was initially diagnosed as hydronephrosis due to the presence of neurogenic bladder and bladder dysfunction. The result of the water deprivation test, which was conducted for persistent diluted polyuria, yielded a final diagnosis of central diabetes insipidus, notwithstanding the strong impression of post-obstructive diuresis initially made because of a sudden increase in urine output after an indwelling catheter was inserted for bladder decompression.

Keyword

diabetes insipidus; obstructive nephropathy; post-obstructive diuresis

MeSH Terms

Catheters, Indwelling
Decompression
Diabetes Insipidus
Diabetes Insipidus, Neurogenic
Diuresis
Humans
Hydronephrosis
Kidney Diseases
Nocturia
Polyuria
Urinary Bladder
Urinary Bladder, Neurogenic
Water Deprivation

Figure

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  Fig. 1 Kidney US. Ultrasonogram shows increased both kidneys in size and calyceal, renal pelvis dilatation. Bilateral ureters are dilated and bladder is distended. Also, bladder shows lobulated outer contour.

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  Fig. 2 Water deprivation test. After pitression injection, urine osmolarity increased from 171 mOsm/kg up to 295 mOsm/kg.

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  Fig. 3 Brain MRI. Brain T1W1 images show "bright spot" in posterior pituitary gland.

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