Nephrogenic Diabetes Insipidus Induced by Lobenzarit Disodium Treatment in Patients with Rheumatoid Arthritis.

Abstract

Nephrogenic diabetes insipidus (NDI) occurred in a 43-year-old woman who had received lobenzarit disodium for the treatment of rheumatoid arthritis (RA). Her urine output was initially 3 //day and urine osmolarity was 203 mOsm//. Based on a sodium chloride loading test and a vasopressin loading test, she was diagnosed as having lobenzarit-induced NDI. Seven days after the cessation of the use of lobenzarit disodium, polydipsia and polyuria disappeared, and the vasopressin test showed a normal response. These findings suggest that lobenzarit induces a reversible form ofNDI as a side effect. The reports oflobenzarit-induced NDI in Japan during the past seven years are also reviewed.

Lobenzarit disodium-induced hyperkalemia successfully treated with fludrocortisone acetate

“…Tubulointerstitial nephritis, nephrogenic diabetes insipidus, hyperkalemia, and acute renal failure have been reported in RA patients treated with CCA. 3 Two broad categories of renal disorders can be distinguished in RA: lesions caused by the disease itself and lesions occurring as a result of side effects of therapeutic agents. As an example of the former, secondary amyloidosis has been reported to occur in 5% to 10% of patients with long-standing arthritis.…”

“…1,2 The most frequently occurring side effect of CCA is gastrointestinal upset, although nephrogenic diabetes insipidus, hyperkalemia, interstitial nephritis, and acute renal failure have also been reported. 3 Here, we report a unique case of hyperkalemia and tubulointerstitial nephritis induced by CCA; the patient was successfully treated with fludrocortisone acetate, a synthetic mineralocorticoid.…”