TY - JOUR
T1 - Treatment of nephrogenic diabetes insipidus with prostaglandin synthesis inhibitors
AU - Libber, Samuel
AU - Harrison, Harold
AU - Spector, David
N1 - Funding Information:
Computational assistance was received from CLINFO, sponsored by National Institutes of Health Grant 5M01RR35-20. Submitted for publication May 19, 1985; accepted July 24, 1985. Reprint requests: David Spector, M.D., Division of Renal Medicine, B2N, Francis Scott Key Medical Center, 4940 Eastern Ave., Baltimore, MD 21224.
PY - 1986/2
Y1 - 1986/2
N2 - The antidiuretic effect of two prostaglandin synthetase inhibitors, ibuproten (25 mg/kg/day) and indomethacin (2 mg/kg/day), was studied in patients aged 8 to 18 years with hereditary nephrogenic diabetes insipidus. Ibuprofen (studied in five patients) did not have demonstrable effects on urine volume, free water clearance, or osmolar clearance, but fractional excretion of sodium ecreased from a mean of 0.38% to 0.19% (P<0.05). In contrast, indomethacin (studied in three patients) was associated with a decrease in mean urine volume from 5.8 to 2.8 mL/min and a decrease in mean free water clearance from 3.1 to 1.1 mL/min (both P<0.05). Fractional excretion of sodium decreased from 0.77% to 0.27% (P<0.01) and was accompained by an increase in serum urea nitrogen level (P<0.01) and a decrease in urea nitrogen clearance (P<0.025). Thus, prostaglandin synthetase inhibitors are not uniformly effective in treatment of nephrogenic diabetes insipidus. The inhibitory effect of indomethacin on urine volume and free water clearance in our patients may have been mediated by an enhancement of antidiuretic hormone (ADH)-stimulated cyclic adenosine monophosphate generation, or by increased ADH-independent water reabsorption resulting from an increase in solute reabsorption and consequent medullary hypertonicity.
AB - The antidiuretic effect of two prostaglandin synthetase inhibitors, ibuproten (25 mg/kg/day) and indomethacin (2 mg/kg/day), was studied in patients aged 8 to 18 years with hereditary nephrogenic diabetes insipidus. Ibuprofen (studied in five patients) did not have demonstrable effects on urine volume, free water clearance, or osmolar clearance, but fractional excretion of sodium ecreased from a mean of 0.38% to 0.19% (P<0.05). In contrast, indomethacin (studied in three patients) was associated with a decrease in mean urine volume from 5.8 to 2.8 mL/min and a decrease in mean free water clearance from 3.1 to 1.1 mL/min (both P<0.05). Fractional excretion of sodium decreased from 0.77% to 0.27% (P<0.01) and was accompained by an increase in serum urea nitrogen level (P<0.01) and a decrease in urea nitrogen clearance (P<0.025). Thus, prostaglandin synthetase inhibitors are not uniformly effective in treatment of nephrogenic diabetes insipidus. The inhibitory effect of indomethacin on urine volume and free water clearance in our patients may have been mediated by an enhancement of antidiuretic hormone (ADH)-stimulated cyclic adenosine monophosphate generation, or by increased ADH-independent water reabsorption resulting from an increase in solute reabsorption and consequent medullary hypertonicity.
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U2 - 10.1016/S0022-3476(86)81010-1
DO - 10.1016/S0022-3476(86)81010-1
M3 - Article
C2 - 3080575
AN - SCOPUS:0022625324
VL - 108
SP - 305
EP - 311
JO - Journal of Pediatrics
JF - Journal of Pediatrics
SN - 0022-3476
IS - 2
ER -