Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul;26(7):846-852.
doi: 10.5005/jp-journals-10071-24244.

Diabetes Insipidus after Vasopressin Withdrawal: A Scoping Review

Raquel S Pérsico  1 , Marina V Viana  2 , Luciana V Viana  3
Affiliations

Diabetes Insipidus after Vasopressin Withdrawal: A Scoping Review

Raquel S Pérsico et al. Indian J Crit Care Med. 2022 Jul.

Abstract

Objectives: The objective of this study is to synthesize the current literature about the relationship between the occurrence of diabetes insipidus (DI), its diagnosis criteria, and management after withdrawal of vasopressin (VP) in critically ill.

Data sources: This scoping review followed the recommendations of Preferred Reporting Items for Systematic Review and Meta-Analyses for Scoping Review (PRISMA-ScR). The search literature was conducted in MEDLINE and EMBASE databases, until March 2022. A manual search was also conducted in order to include articles that were not identified in the initial search performed in the databases.

Study selection and data extraction: The selection of studies and extraction of data were carried out in a paired and independent manner. There was no restriction regarding the language of publication of the included manuscripts.

Data synthesis: The analysis included 17 studies (16 case reports and one retrospective cohort). All studies used VP, with a median time of drug infusion of 48 hours (IQR: 16-72) and DI incidence of 1.53%. The diagnosis of DI was based on diuresis output and concomitant hypernatremia or changes in serum sodium concentration, with median time to symptoms onset after discontinuation of VP of 5 hours (IQR: 3-10). The treatment of DI consisted mainly of fluid management and the use of desmopressin.

Conclusions: DI after VP withdrawal was present in 51 patients described in 17 studies, but diagnosis and management varied among each report. Using the available data, we propose a diagnosis suggestion and a flowchart for managing patients with DI after withdrawal of VP in the Intensive Care Unit. Multicentric collaborative research is urgently needed to obtain more quality data on this topic.

How to cite this article: Pérsico RS, Viana MV, Viana LV. Diabetes Insipidus after Vasopressin Withdrawal: A Scoping Review. Indian J Crit Care Med 2022;26(7):846-852.

Keywords: Arginine vasopressin; Critical care; Diabetes insipidus; Hypernatremia; Intensive care units.

PubMed Disclaimer

Conflict of interest statement

Source of support: Nil Conflict of interest: None

Figures

Flowchart 1
Flowchart 1
Flowchart of the proposed treatment of diabetes insipidus after withdrawal of vasopressin
Flowchart 2
Flowchart 2
Flowchart of Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA)
See this image and copyright information in PMC

References

    1. Ukor IF, Walley KR. Vasopressin in vasodilatory shock. Crit Care Clin. 2019;35(2):247–261. doi: 10.1016/j.ccc.2018.11.004. - DOI - PubMed
    1. Bankir L, Bichet DG, Morgenthaler NG. Vasopressin: physiology, assessment and osmosensation. J Intern Med. 2017;282(4):284–297. doi: 10.1111/joim.12645. - DOI - PubMed
    1. Goldsmith SR. Vasopressin as vasopressor. Am J Med. 1987;82(6):1213–1219. doi: 10.1016/0002-9343(87)90228-2. - DOI - PubMed
    1. Christ-Crain M, Bichet DG, Fenske WK, Goldman MB, Ritting S, Verbalis JG, et al. Diabetes insipidus. Nat Rev Dis Primers. 2019;5(1):1–20. doi: 10.1038/s41572-019-0103-2. - DOI - PubMed
    1. Harrois A, Anstey JR. Diabetes insipidus and syndrome of inappropriate antidiuretic hormone in critically ill patients. Crit Care Clin. 2019;35(2):187–200. doi: 10.1016/j.ccc.2018.11.001. - DOI - PubMed

Publication types

LinkOut - more resources