論文

査読有り
2021年4月

Unusual ischemic kidney injury presenting as slowly declining graft function and successful use of oral desmopressin in a kidney transplant recipient with subclinical central diabetes insipidus

Clinical nephrology
  • Kaneko, Shuzo
  • ,
  • Usui, Joichi
  • ,
  • Kawanishi, Kunio
  • ,
  • Ishii, Ryota
  • ,
  • Takahashi, Kazuhiro
  • ,
  • Suzuki, Hiroaki
  • ,
  • Saito, Chie
  • ,
  • Oda, Tatsuya
  • ,
  • Nagata, Michio
  • ,
  • Yamagata, Kunihiro

94
4
開始ページ
208
終了ページ
214
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.5414/CN110295

Polyuria in post-kidney transplant (KT) patients is a common condition generally attributed to delayed tubular function, fluid administration, and solute diuresis. Since excessive water intake post-KT physiologically suppresses arginine vasopressin (AVP) secretion, central diabetes insipidus (CDI) caused by deficient primary AVP release can be overlooked. Although DDAVP (desmopressin) - a selective AVP V2 receptor agonist - has been used to treat massive polyuria, CDI rarely progresses to kidney injury due to the preservation of fluid balance by thirst-dependent osmoregulation. Administration of DDAVP in post-KT recipients with mild polyuria and subclinical CDI is difficult to assess, and whether long-term use of DDAVP is beneficial for the transplanted kidney has not been established. We present the case of a 36-year-old Japanese female who was diagnosed with subclinical/partial CDI post KT. CDI was caused by a sequela of suprasellar germinoma. Graft function gradually declined without evidence of hypovolemia or hypernatremia, and a kidney biopsy revealed advanced ischemic kidney injury. Although daily oral DDAVP administration did not increase extracellular fluid volume, treatment resulted in a gradual improvement of graft function, and a follow-up transplanted kidney biopsy indicated substantial recovery.

リンク情報
DOI
https://doi.org/10.5414/CN110295
ID情報
  • DOI : 10.5414/CN110295
  • ISSN : 0301-0430

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