Lithium-induced Nephrogenic Diabetes Insipidus with Efficacy of Desmopressin in Combination with Thiazide Diuretics and Non-steroidal Anti-inflammatory Drugs: A Case Report with a Review of the Literature

Intern Med. 2024 May 15;63(10):1399-1404. doi: 10.2169/internalmedicine.2437-23. Epub 2023 Sep 29.

Abstract

Nephrogenic diabetes insipidus (NDI) is characterized by excessive urination and an inability to concentrate urine. Lithium is the most common cause of acquired NDI. Treatment typically involves thiazide diuretics and nonsteroidal anti-inflammatory drugs (NSAIDs). However, the efficacy of desmopressin in NDI remains unclear. We herein report a case of lithium-induced NDI in a 71-year-old woman with lithium-induced NDI. Thiazide diuretics and NSAIDs reduced the urine output by approximately 40% compared to pretreatment, while the addition of desmopressin reduced it by approximately 70%. This case suggests that desmopressin can be a viable treatment option for lithium-induced NDI.

Keywords: desmopressin; lithium; nephrogenic diabetes insipidus; non-steroidal anti-inflammatory drugs; thiazide diuretics.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal* / adverse effects
  • Antidiuretic Agents / administration & dosage
  • Antidiuretic Agents / adverse effects
  • Antidiuretic Agents / therapeutic use
  • Deamino Arginine Vasopressin* / administration & dosage
  • Deamino Arginine Vasopressin* / adverse effects
  • Deamino Arginine Vasopressin* / therapeutic use
  • Diabetes Insipidus, Nephrogenic* / chemically induced
  • Diabetes Insipidus, Nephrogenic* / drug therapy
  • Drug Therapy, Combination*
  • Female
  • Humans
  • Lithium / adverse effects
  • Lithium / therapeutic use
  • Sodium Chloride Symporter Inhibitors* / adverse effects
  • Sodium Chloride Symporter Inhibitors* / therapeutic use
  • Treatment Outcome