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At least 883 records · Page 49Linked to original sources
PubMed1993

Urinary arginine vasopressin (AVP) measurement in children: water deprivation test incorporating urinary AVP.

The value of a water deprivation test incorporating urinary arginine vasopressin (AVP) measurement was investigated in 13 patients with polydipsia and/or polyuria (complete central diabetes insipidus [CCDI] in four; incomplete central diabetes insipidus [ICDI] in five; secondary nephrogenic diabetes insipidus [NDI] in three; compulsive water drinking [CWD] in one) and a group of 25 control subjects (C). Urine samples were collected after water deprivation during sleep and the urinary osmolalities and AVP concentrations were measured. Analysis of the results of 104 urine samples from the 25 control subjects demonstrated a close correlation between urinary osmolality and AVP (r = 0.89, P < 0.001). After water deprivation during sleep, the respective mean maximal urinary osmolalities and AVP concentrations were: 127.4 +/- 34.4 mOsm/kg and 1.1 +/- 0.5 pg/mL in the patients with CCDI (14 samples, four children); 410.3 +/- 101.8 and 6.1 +/- 3.5 in those with ICDI (16 samples, five children); 348.7 +/- 71.2 and 100 +/- 45.1 in those with NDI (nine samples, three children); 541.5 +/- 143.5 and 43.6 +/- 33.2 in the patient with CWD (two samples, one child) and 898.8 +/- 186.3 and 97.4 +/- 50.4 in group C (54 samples, 18 children). Furthermore, the urinary AVP level relative to the osmolality in each patient varied depending on the AVP secretion status and renal concentrating ability. Each patient, except the one with CWD, could be discriminated from the normal subjects using this test. It seems that this test is easy to perform and useful for diagnosis and follow-up of patients with partial/complete posterior pituitary function defects and those with renal concentration impairment.

Adolescent↗
PubMedDate not supplied

Self-care behaviour and blood glucose control in young adults with type 1 diabetes mellitus.

Self-care behaviour, knowledge about diabetes, and blood glucose control were studied in 113 young adults with Type 1 diabetes using a semi-structured interview, self-report questionnaires, and a biochemical measure (glycated haemoglobin). The majority of subjects followed their prescribed regimen reasonably accurately, but individuals followed different aspects of the regimen to different degrees. Subjects were more concerned with the avoidance of hypoglycaemia than with attainment of 'tight' blood glucose control. The blood glucose test level at which subjects took remedial action was the best single predictor of symptomatic control. Frequency of nocturnal polyuria appeared to be a reliable indicator of impaired metabolic control. Insulin omission or dose reduction for the purpose of body weight reduction was common among women, who also had worse blood glucose control than men. Elevated glycated haemoglobin levels were associated with higher alcohol consumption in men. Theoretical knowledge about diabetes management was only weakly associated with self-care behaviour and blood glucose control in this population. The blood glucose test result at which subjects take remedial action appears to be the most appropriate behavioural target for intervention to improve control in such subjects.

Adolescent↗
PubMed1994

Transient diabetes insipidus and acute fatty liver of pregnancy.

OBJECTIVE: To review the association of transient diabetes insipidus and acute fatty liver of pregnancy. DESIGN: A retrospective study. SETTING: Six women presenting with polyuria and polydipsia in the third trimester or in the immediate postpartum period, referred over a two and a half year period; five out of six were primigravida. All had raised liver transaminases and biopsy-proven acute fatty liver of pregnancy. Four out of six also had pre-eclampsia. SUBJECTS: Tertiary referral centre. MAIN OUTCOME MEASURES: There were no maternal deaths and only one fetal death. Desamino-cys-1-D-arg-8-vasopressin administration produced a reduction in urine output in all five women to whom it was administered. In all cases symptoms had resolved by the end of the fourth postpartum week. Three of the women have had subsequent pregnancies uncomplicated by either transient diabetes insipidus or acute fatty liver of pregnancy. CONCLUSIONS: The association of transient diabetes insipidus and acute fatty liver of pregnancy appears more common than previously recognised. Both may be part of the spectrum of pre-eclampsia.

Acute Disease↗
PubMed1976

A comparative double-blind study of the side effects of Litarex and Lithionit Durettes.

Side effects of two lithium salts of the sustained-release type were compared in a cross-over double-blind study. Eighteen patients with uni- or bipolar type of manic-depressive diseases were included in the trial. The drugs compared were lithium citrate (Litarex, Dumex Ltd.) and lithium sulphate (Lithionit Durettes, Hässle Ltd.). After the patients had been adjusted to a serum concentration of 0.8-1.2 mmol/l, self-assessment of the frequency and intensity of 16 side-effect variables was performed during a period of 4 weeks. The most common side effects were tremor, fatigue, polyuria, polydipsia, and reduced power of concentration. There was no difference in the frequency or intensity of the side effects between the two drugs. The side effects are, accordingly, considered an effect of the lithium ion, rather than of the lithium salt. The difference in the size and appearance of the tablets was of very little practical significance.

Adult↗
PubMed1975

Extramedullary plasmacytoma of stomach.

A single case of gastric plasmacytoma showing unusual clinical and pathological features is described. The patient had gluten sensitive enteropathy, and showed increased circulating IgA levels prior to gastrectomy. Progression of the disease was associated with both K and L light chain proteinuria, hypoalbuminaemia, and vasopressin resistant polyuria. Pathological investigation revealed the coexistence of IgA secreting soft tissue plasmacytoma, with IgG secreting myeloma. The significance of these findings is discussed.

Autopsy↗
PubMedDate not supplied

Crossed renal ectopia with fusion in a cat.

In humans, crossed renal ectopia is a rare, usually asymptomatic, congenital malpositioning of the kidneys, involving wandering of one or both embryonic kidneys across the midline and usually fusion with its contralateral partner. This is the first report of crossed renal ectopia in the cat. A 7-year-old, neutered male cat was presented with polyuria, polydipsia, and a palpable abdominal mass. Diagnostic investigations, including clinical pathology, survey and contrast radiography, and ultrasonography, confirmed the presence of an ectopic left kidney fused with an orthotopic right kidney, with concurrent renal failure and hypertension. Many features of crossed renal ectopia in this cat are similar to those described in humans, however the vascular supply, the presence of renal failure, and the axial rotation of the fused kidney are atypical.

Animals↗
PubMedDate not supplied

Chronic renal failure associated with nephrolithiasis, ureterolithiasis, and renal dysplasia in a 2-year-old quarter horse gelding.

A 2-year-old quarter horse gelding presented for evaluation of polyuria and polydipsia. Azotemia was detected on serum chemistry profile. Small, misshapen, hyperechoic kidneys with decreased corticomedullary demarcation, hydronephrosis, and a right nephrolith were noted ultrasonographically. The diagnosis of end-stage kidney disease and dysplasia was made histopathologically using ultrasound-guided biopsy. Two ureteroliths were found in the right ureter via cystoscopy, and a nephrolith was seen in the right kidney at necropsy. Clinical, ultrasonographic, and pathologic features of equine urolithiasis and renal dysplasia are discussed.

Animals↗
PubMed1996

Horner's syndrome associated with a functional thyroid carcinoma in a dog.

A seven-year-old entire male Irish setter was presented because of a neck mass, prolapse of the third eyelid and apparent drooping of the upper eyelid. Historical findings included increased appetite as well as polyuria and polydipsia for about two weeks. The most remarkable findings on physical examination were right-sided Horner's syndrome, pre-scapular lymphadenopathy and a large, ventral cervical mass. Lateral cervical radiographs showed a large, soft tissue opacity surrounding the trachea and retropharyngeal area which was causing displacement and narrowing of the cervical trachea and oesophagus. Results of thyroid testing suggested hyperthyroidism. At necropsy, a large, invasive tumour was identified in the ventral cervical region and multiple metastases of various sizes were detected in the lungs. Histopathological examination of the tumour revealed follicular thyroid carcinoma and confirmed widespread pulmonary metastasis.

Animals↗
PubMed1999

Concurrent central diabetes insipidus and panhypopituitarism in a German shepherd dog.

This report describes a German shepherd dog that was presented with proportionate dwarfism and coat changes typical of hypopituitarism but that was also profoundly polydipsic and polyuric. Investigations established a diagnosis of concurrent central diabetes insipidus. Treatment with desmopressin was successful in managing the polyuria and polydipsia.

Animals↗
PubMed2001

Transient renal tubulopathy in a Labrador retriever.

A four-month-old male Labrador retriever was presented for polyuria, polydipsia and persistent euglycaemic glucosuria. On referral, diagnostic tests demonstrated abnormal fractional excretions of electrolytes, increased urinary excretion of selected amino acids, mild renal tubular acidosis and mild proteinuria, indicating renal tubular dysfunction. Pyelonephritis was suspected and potentiated amoxycillin was administered. On re-evaluation at six months of age, the dog was no longer polyuric or polydipsic and the metabolic abnormalities associated with the tubulopathy had resolved. Transient Fanconi's syndrome has not previously been reported in small animals. This report demonstrates the potential for recovery of function in cases presenting with renal tubulopathies.

Amoxicillin↗
PubMed2005

Primary hyperparathyroidism in 29 dogs: diagnosis, treatment, outcome and associated renal failure.

OBJECTIVES: To review the records of 29 dogs diagnosed with primary hyperparathyroidism and see if any factors correlate with renal failure. METHODS: Dogs were selected retrospectively from case files from the QVSH and the QMH. RESULTS: The majority of dogs were middle-aged and four were keeshonds. The primary presenting complaints were polyuria and polydipsia. All dogs had an elevated total and ionised plasma calcium concentration. Plasma phosphate concentrations were variable. Ultrasonography of the parathyroid gland revealed nodular enlargement which was found to correlate well with surgical findings. The majority of dogs underwent surgical parathyroidectomy. Five cases were treated by ultrasound-guided chemical ablation of the parathyroid gland, of which only two cases showed a partial response. Three dogs were euthanased within a week of presentation. Seven other dogs had renal failure diagnosed either at presentation or up to six months after parathyroidectomy. The development of renal failure was correlated with total calcium concentration but did not correlate with any other factor, including the calcium phosphate product. Thirteen treated dogs were known to be alive at the time of writing, which was six months to 3.5 years after parathyroidectomy. CLINICAL SIGNIFICANCE: Primary hyperparathyroidism cases with high total calcium were more likely to develop renal failure in this group of dogs; however, the calcium phosphate product did not seem to be a useful predictor. Ultrasound-guided chemical ablation seemed to have limited advantage over surgery.

Animals↗
PubMed1968

The function of antidiuretic hormone in the sheep.

1. With the aim of producing diabetes insipidus in sheep, electrolytic lesions were placed in the ventral medial hypothalamus immediately posterior to the optic chiasm.2. After formation of lesions, the pattern of urine excretion showed a triphasic response consisting of (i) an immediate diuresis reaching a maximum within 4 days, (ii) an interphase of about 12 days wherein rates of urine flow were normal, and (iii) a final phase of permanent polyuria. With the four sheep used in this work, the time between placement of the lesions and onset of permanent hyposthenuria was 19-22 days.3. In the final polyuric phase, the sheep were unable to concentrate their urine in response to dehydration or to feeding.4. Infusions of arginine vasopressin restored the ability of these animals to excrete urine that was hypertonic to plasma.5. The evidence showed that the hypothalamic lesions were effective in producing permanent diabetes insipidus. It was concluded that anti-diuretic hormone (ADH) has essentially the same function in sheep as it has in other mammalian species; that is, the hormone facilitates the elaboration of hypertonic urine. There was no evidence to suggest that ADH had a special effect on potassium excretion in the sheep.

Animals↗
PubMed1968

Abnormal water balance in a mutant strain of chickens.

Polydipsia and polyuria are pronounced in chickens of a selected strain and this diabetes insipidus is inherited. The kidneys of such birds are capable of an antidiuretic response when lysine vasopressin or arginine vasotocin is injected. Osmotic pressure and sodium concentration of the plasmas of normal and mutant chickens are identical. Chicks predicted to have diabetes insipidus on the basis of parental pedigree are polydipsic.

Animals↗
PubMed1999

Dose related growth response to indometacin in Gitelman syndrome.

Growth failure is a recognised feature of Gitelman syndrome, although it is not as frequent as in Bartter syndrome. Indometacin is reported to improve growth in Bartter syndrome, but not in Gitelman syndrome, where magnesium supplements are recommended. This paper presents 3 sisters with Gitelman syndrome who could not tolerate magnesium supplements, and whose hypotension and polyuria were eliminated by taking 2 mg/kg/day indometacin, but who grew poorly. However, increasing the indometacin dose to 4 mg/kg/day improved their growth significantly, without changing their symptoms or biochemistry. Gastrointestinal haemorrhage necessitated the use of misoprostol.

Bartter Syndrome↗
PubMed1979

Renal function after long-term treatment with lithium.

Daily urine volumes, plasma creatinine concentrations, and creatinine clearance were measured in 106 patients with unipolar and bipolar affective disorders attending a "lithium" clinic. Urine volumes exceeded 3.51 in only six patients, plasma creatinine concentrations exceeded 150 mumol/1 (1.7 mg/100 ml) in only five, and creatinine clearance was below 50 ml/min in 16. Renal function was assessed by measuring creatinine clearance and renal tubular function, including response to 20 hours of water deprivation, in a representative sample of 30 patients from the lithium clinic and 30 psychiatric patients matched for age and sex who were taking other psychotropic drugs. Creatinine clearance and tubular function, including urine osmolality after water deprivation, were not significantly different between the two groups. Urinary excretion of arginine vasopressin (AVP), however, was much greater in the lithium-treated patients, who therefore had a diminished tubular responsiveness to AVP. The findings do not support suggestions that long-term lithium treatment results in seriously impaired renal function, renal damage, and polyuria. Compared with other series, however, the patients were being maintained with low serum lithium concentrations, which apparently area as effective prophylactically as higher concentrations.

Adult↗
PubMed1976

Mode of presentation of juvenile diabetes.

In a study of 66 children with juvenile diabetes symptoms had often present for over a month before diagnosis. Though polyuria, polydipsia, and weight loss were the commonest features, other important symptoms included tiredness lethargy, and malaise. A gradual onset of diabetes was commoner than is generally realised.

Adolescent↗
PubMed1974

Blood levels and management of lithium treatment.

The limited value of plasma measurements in the management of treatment with lithium is discussed in the light of the mechanisms of its therapeutic actions and toxic effects.The plasma level of lithium usually rises twofold or threefold in the three to five hours after ingestion of each dose of delayed-release tablets and then gradually falls. The precise shape and height of the lithium curve depend on gastric emptying, which can be slowed with propantheline or speeded with metoclopramide. Depressed or demented patients may be irregular in taking their tablets and variable in food intake. Both the time of the blood test and this behaviour must be considered before changing the prescribed dose of lithium salt because of a laboratory result. A lithium tolerance curve may be a safer guide to treatment than single measures.Mild intermittent thirst is a common early side effect, and severe persistent thirst with polyuria is an uncommon later effect of daily intakes of at least 1,500 mg lithium carbonate. This diabetes insipidus is reversible, non-progressive, unrelated to plasma level, and distinct in attack from lithium-induced hypothyroidism, which may occur at low dosage but is also usually of late onset and reversible or treatable with thyroxine while lithium is continued. Obesity is another occasional effect of large doses. These side effects and the antimanic and prophylactic effects may have different mechanisms.

Administration, Oral↗