deamino-arginine-vasopressin and Intellectual-Disability

Topics: Amino Acid Sequence; Aquaporin 2; Aquaporin 6; Aquaporins; Arginine Vasopressin; Deamino Arginine Vasopressin; Dehydration; Diabetes Insipidus, Nephrogenic; Drug Resistance; Female; Founder Effect; Genetic Carrier Screening; Genetic Heterogeneity; History, 17th Century; History, 18th Century; Humans; Incidence; Infant; Infant, Newborn; Intellectual Disability; Ion Channels; Ireland; Kidney Failure, Chronic; Male; Models, Biological; Models, Molecular; Molecular Sequence Data; Mutation; Nephrons; Nova Scotia; Prenatal Diagnosis; Prevalence; Protein Conformation; Receptors, Vasopressin; X Chromosome

Disequilibrium syndrome (DS) is a central nervous system disorder described in hemodialysis (HD) patients. The authors present 4 cases of elevated blood urea nitrogen (BUN); the first patient passed away from suspected DS, whereas the other 3 patients were identified as having a high risk of developing DS on the basis of their BUN. The authors tried to lower their BUN slowly and prevent rapid correction by different methods. This is the first study in which DS has been studied in patients who are not on HD, and methods are described to identify and prevent DS in such patients. They also review the existing literature on the pathogenesis of DS and highlight the importance of recognizing this syndrome in non-HD patients, while suggesting some innovative ways to prevent it.

Topics: Aged; Antidiuretic Agents; Blood Urea Nitrogen; Cerebellar Ataxia; Deamino Arginine Vasopressin; Disease Management; Female; Fluid Therapy; Humans; Hyperglycemic Hyperosmolar Nonketotic Coma; Intellectual Disability; Male; Middle Aged; Treatment Outcome; Urethral Obstruction; Urinary Catheterization; Water-Electrolyte Imbalance

Topics: Adult; Deamino Arginine Vasopressin; Enuresis; Humans; Hyponatremia; Intellectual Disability; Male; Renal Agents; Seizures

More than 250,000 patients with nocturnal enuresis have been treated with DDAVP in the United States since 1989. It adequately controls nocturnal enuresis in over half of patients with significant improvement in their quality of life. Although the overall incidence of adverse effects associated with treatment of nocturnal enuresis with DDAVP is low, it is not a benign drug particularly when used in patients at extreme of age. A review of the literature and the present case demonstrate that the potential risk factors for hyponatremia following administration of DDAVP include hepatic disease, surgery, stress, pain, renal disorder, excessive fluid intake, and increased dose of DDAVP. Potentially serious side effects of DDAVP administration such as hyponatremia and seizure may be prevented by close monitoring of serum electrolytes, urine output, as well as fluid restriction and avoidance of solutions with low-sodium content.

Topics: Adult; Cerebral Palsy; Deamino Arginine Vasopressin; Drug Monitoring; Enuresis; Humans; Hyponatremia; Intellectual Disability; Male; Renal Agents; Risk Factors; Sodium

Topics: Abnormalities, Multiple; Brain; Chromosome Aberrations; Chromosome Deletion; Chromosome Disorders; Chromosomes, Human, 16-18; Deamino Arginine Vasopressin; Diabetes Insipidus; Female; Humans; Infant; Infant, Newborn; Intellectual Disability