Hyperuricemia as a Clue for Central Diabetes Insipidus (Lack of V1 Effect) in the Differential Diagnosis of Polydipsia

Short-term effects of tolvaptan on renal function and volume in patients with autosomal dominant polycystic kidney disease

“…Administration of tolvaptan resulted in a reduction in uric acid clearance and an increase in serum uric acid levels that were more marked than changes in GFR and levels of serum creatinine and cystatin C. An elevation in serum uric acid is a characteristic of both central and nephrogenic diabetes insipidus. 29,30 It has been suggested that the degree of the elevation may be more marked in central than in nephrogenic diabetes insipidus because stimulation of V1a receptors may have a uricosuric effect. 29 Changes in uric acid clearance often closely correlate with changes in RBF.…”

Diagnosis and management of diabetes insipidus for the internist: an update

“…AVP deficiency in central DI is associated with chronic low uric acid clearance and hyperuricaemia. Volaemia is an important determinant of uric acid regulation, but AVP by its action on AVPR1 has also been speculated to play a role in uric acid clearance [33,34,35]. The clinical consequence of the potentially altered uric acid metabolism in DI patients remains unclear.…”

Juvenile-onset gout and adipsic diabetes insipidus: A case report and literature review

“…The serum UA level is partially dependent on renal clearance, which is influenced by different factors, among which establishment of effective normovolemia has a major influence. 13 – 15 Our patient’s laboratory parameters were obviously improved after treatment with desmopressin and increased daily water intake. However, the serum UA level increased again during follow-up, and his urate clearance was very low after treatment.…”

“…16 Thus, hyperuricemia in a patient with normonatremia, polydipsia, and polyuria is thought to be highly suggestive of CDI. 14 There are three types of vasopressin receptors: V1, V2, and V3. The V2 receptor is mainly distributed in the basement membrane of the collecting duct where it increases the reabsorption of water and concentrates the urine, playing the role of antidiuresis.…”