A case of transient central diabetes insipidus after aorto-coronary bypass operation

J Korean Med Sci. 2012 Sep;27(9):1109-13. doi: 10.3346/jkms.2012.27.9.1109. Epub 2012 Aug 22.

Abstract

Diabetes insipidus (DI) is characterized by excessive urination and thirst. This disease results from inadequate output of antidiuretic hormone (ADH) from the pituitary gland or the absence of the normal response to ADH in the kidney. We present a case of transient central DI in a patient who underwent a cardiopulmonary bypass (CPB) for coronary artery bypass grafting (CABG). A 44-yr-old male underwent a CABG operation. An hour after the operation, the patient developed polyuria and was diagnosed with central DI. The patient responded to desmopressin and completely recovered five days after surgery. It is probable that transient cerebral ischemia resulted in the dysfunction of osmotic receptors in the hypothalamus or hypothalamus-pituitary axis during CPB. It is also possible that cardiac standstill altered the left atrial non-osmotic receptor function and suppressed ADH release. Therefore, we suggest that central DI is a possible cause of polyuria after CPB.

Keywords: Aorto-Coronary Bypass; Central Diabetes Insipidus; Polyuria.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antidiuretic Agents / therapeutic use
  • Coronary Artery Bypass / adverse effects*
  • Coronary Vessels
  • Deamino Arginine Vasopressin / therapeutic use
  • Diabetes Insipidus, Neurogenic / diagnosis*
  • Diabetes Insipidus, Neurogenic / drug therapy
  • Diabetes Insipidus, Neurogenic / etiology
  • Humans
  • Hypothalamus / diagnostic imaging
  • Magnetic Resonance Imaging
  • Male
  • Pituitary Gland / diagnostic imaging
  • Polyuria / diagnosis
  • Polyuria / etiology
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / drug therapy
  • Postoperative Complications / etiology
  • Radionuclide Imaging

Substances

  • Antidiuretic Agents
  • Deamino Arginine Vasopressin