Adipsia increases risk of death in patients with central diabetes insipidus
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- Arima Hiroshi
- Department of Endocrinology and Diabetes, Field of Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
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- Wakabayashi Toshihiko
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
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- Nagatani Tetsuya
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
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- Fujii Masazumi
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
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- Hirakawa Akihiro
- Biostatistics Section, Center for Advanced Medicine and Clinical Research, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
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- Murase Takashi
- Department of Endocrinology and Diabetes, National Hospital Organization Nagoya Medical Center, Nagoya 460-0001, Japan
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- Yambe Yuko
- Department of Endocrinology and Diabetes, National Hospital Organization Nagoya Medical Center, Nagoya 460-0001, Japan
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- Yamada Tsutomu
- Department of Endocrinology and Diabetes, National Hospital Organization Nagoya Medical Center, Nagoya 460-0001, Japan
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- Yamakawa Fumiko
- Department of Endocrinology and Diabetes, National Hospital Organization Nagoya Medical Center, Nagoya 460-0001, Japan
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- Yamamori Ikuo
- Department of Endocrinology and Metabolism, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya 453-8511, Japan
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- Yamauchi Masako
- Department of Endocrinology and Metabolism, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya 453-8511, Japan
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- Oiso Yutaka
- Department of Endocrinology and Diabetes, Field of Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
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抄録
Central diabetes insipidus (CDI) is caused by deficiency of arginine vasopressin, an antidiuretic hormone. Patients with CDI manifest polyuria which is usually compensated for by increases in water intake. However, some patients are not able to sense thirst due to the destruction of osmoreceptors in the hypothalamus. These adipsic CDI patients are easily dehydrated and the consequent dehydration could be life-threatening. The objective of this study was to investigate the prognosis of adipsic CDI patients. We have reviewed 149 patients with CDI in three hospitals using databases of the electronic medical recording systems, and examined whether adipsia could affect the morbidity and mortality in CDI patients with multivariable analyses. Twenty-three patients with CDI were adipsic while the remaining 126 patients were non-adipsic. The multivariate analyses showed that the incidence of serious infections which required hospitalization was significantly higher in the adipsic CDI patients compared to that in non-adipsic CDI patients (p <0.001). A total of 6 patients with CDI died during the follow-up (median duration; 60 months, range 1 to 132 months). Four of them were adipsic, three of whom died of infection. The statistical analyses revealed that the risk of death in adipsic CDI patients was significantly higher than in non-adipsic patients (p =0.007). It is thus suggested that adipsic CDI patients were susceptible to serious infections which could be the causes of death.
収録刊行物
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- Endocrine Journal
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Endocrine Journal 61 (2), 143-148, 2014
一般社団法人 日本内分泌学会