Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0028961 (oliguria)
 1,847 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 20-yr-old male was found to have diabetes insipidus is association with panhypopituitarism but without any focal neurological lesion being identified. He was initially treated with steroid supplements, the features of diabetes insipidus being controlled with a thiazide diuretic. Eighteen months later the patient lost thirst sensation and stopped treatment, subsequently being re-admitted with severe dehydration, oliguria and focal neurological signs. Further investigation, including brain biopsy, confirmed the presence of an atypical pinealoma which was considered inoperable. Measurements of plasma antidiuretic hormone (ADH) and angiotensin II (AII) concentrations during the severe dehydration showed very high levels of AII, but inappropriately low plasma ADH levels for the severity of dehydration. We consider that the evidence obtained from this case supports the view that the oliguria with hypertonic urine present during severe dehydration was due to a direct renal action of the very high AII levels, possibly supplemented by the residual ADH secretion.
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PMID:A case of hypopituitarism with diabetes insipidus and loss of thirst. Role of antidiuretic hormone and angiotensin II in the control of urine flow and osmolality. 117 97

A disturbed water and electrolyte homeostasis is not generally held to be a primary mechanism in the pathogenesis of acute mountain sickness (AMS) and high altitude pulmonary edema (HAPE), but the association of oliguria and weight gain with AMS and HAPE has led to the hypothesis that water retention may be a facilitative mechanism, possibly caused by an effect of hypoxia to release antidiuretic hormone (ADH). To examine the problem, normal Long-Evans rats (N) and the strain with congenital diabetes insipidus (DI) were exposed to hypobaric hypoxia (0.5 atm) for 4 days, and fluid balance in the whole animals and in their lungs was studied. Both strains reduced water intake and were oliguric on acute exposure, but the N rats gained body weight and increased lung water, while the DI rats increased neither body weight nor lung water. Neither strain increased lung blood at high altitude. The oliguria in the DI rats could not have been due to a release of antidiuretic hormone, and was attributed to the diminished water intake in both strains. The protection against HAPE in the DI rats was probably due to their more severe dehydration that exists already in normoxia, and its further increase in hypoxia, compared with N rats.
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PMID:Water balance and lung fluids in rats at high altitude. 160 61

An increasing number of anaesthetists is being called upon to manage organ donors during organ retrieval procedures. We briefly describe the technical aspects of the surgical procedure together with a guide to the anaesthetic management. The aims of the latter may be summarized as the "Rule of 100": systolic blood pressure greater than 100 mmHg, urine output greater than 100 ml.hr-1, PaO2 greater than 100 mmHg, haemoglobin concentration greater than 100 g.L-1. Common management problems (hypotension, arrhythmias, diabetes insipidus, oliguria, and coagulopathy) are discussed in detail. The intraoperative management of the brain-dead organ donor provides the anaesthetist with the challenge of a major surgical procedure in a subject with important physiological derangements.
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PMID:Anaesthetic management of the brain dead for organ donation. 222 1

Acute cerebral compression by a supra- and infratentorial balloon produced a triphasic pattern of diuresis. The 1st phase was characterized by polyuria associated with five fold increase of plasma (p) antidiuretic hormone (ADH) concentration, decreased urine osmolality in spite of natriuresis and blood pressure elevation. The 2nd phase was characterized by oliguria, a decrease of pADH and reduced urine Na+ concentration, whereas urine osmolality transiently increased. At this stage there was respiratory arrest and fall of blood pressure. The final stage was diabetes insipidus (DI), when EEG activity had disappeared. An increase of serum osmolality mainly occurred during the last DI phase. Serum Na+ concentration fluctuated slightly during the whole period of diuresis. These results present evidence, that the diuresis pattern reflects the hypothalamo-hypophyseal antidiuretic system (HHAS) reaction to acute intracranial pressure (ICP) increase with the vegetative symptoms of cerebral shock.
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PMID:Dissociation between activation of the hypothalamo-hypophyseal antidiuretic system and the type of diuresis during acute intracranial hypertension. Experimental observation. 292 92

Injection of a synthetic progesterone, medroxyprogesterone acetate (MPA or Depo-ProveraR), a widely used contraceptive, into Chinese hamsters (Cricetulus griseus) induced a profound polyuria with daily output of dilute urine equal to about 50% body weight of the hamster. However, relatively normal ability for renal urine concentration was demonstrated by administration of exogenous vasopressin. Body weight did not increase during onset of MPA-induced polyuria or during interval of vasopressin-induced oliguria, suggesting that primary polydipsia was not etiologic. Administration of this steroid to Chinese hamsters was nontoxic, although these polyuric animals were unusually sensitive to water deprivation. This polyuria was not observed when progesterone alone was injected into Chinese hamsters or when MPA was given to other related hamster species (Armenian, Syrian, Turkish or Djzungarian). The MPA-injected Chinese hamster represents a unique model of vasopressin sensitive diabetes insipidus induced by a steroid in a species-specific fashion.
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PMID:Medroxyprogesterone acetate induces diabetes insipidus in Chinese hamsters. 293 35

Cerebral death is often associated with haemodynamic changes which include a decrease in cardiac output and peripheral resistance. Brain-death following head injury may also lead to acquired diabetes insipidus with secondary water and electrolyte derangement. It is therefore necessary to prevent and correct these alterations, particularly when long-term maintenance is required, in order to keep kidney function within the normal range. Computerized monitoring of renal function and electrolyte and water derangements has been adopted. In all cases where early data of renal failure or oliguria were present infusions of dopamine and fluids were started. When indicated, the optimal dose of dopamine was calculated using a computerized system to allow drug dosages and the time of haemodynamic derangement to be minimized. When acquired central diabetes insipidus was present and urine output greater than 4 ml kg-1 h-1 desamino-cis-D-arginine vasopressin (DDAVP) was administered.
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PMID:Maintenance of unstable kidney donors. 353 93

The role of blood volume regulatory mechanisms located in the low pressure system in the control of urinary excretion was studied using hypobaric pressure breathing in normal and diabetes insipidus (Brattleboro strain with a congenital lack of vasopressin) rats. Rats were placed in an altitude simulator chamber for 4 h. A pump maintained pressure reduced to 701, 577 and 472 mbar simulating respectively altitude of 3,000, 4,500 and 6,000 m. In normal rats, hypobaric breathing induced an increase in urine flow, urinary urea and K+ excretion and urinary pH but did not significantly modify creatinine and Na+ excretion. In diabetes insipidus rats, hypobaric breathing produced oliguria and an decrease in urea, creatinine, Na+, K+, Cl- urinary excretions. Since acute hypobaric pressure breathing induced opposed effects in normal and Brattleboro rats, it is suggested that this kind of experimental procedure which increases intrathoracic blood volume elicits a diuretic response through an inhibition of vasopressin release. These experiments confirm the main role of vasopressin in the control of central blood volume.
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PMID:Renal effect of acute hypobaric pressure breathing in normal and diabetes insipidus rats. 376 Dec 5

The renal effects of clonidine (100 and 500 micrograms/kg s.c.) during acute hypobaric pressure breathing (i.e. a protocol which induces an increase in intrathoracic blood volume) were studied in normal and diabetes insipidus rats. In normal rats, clonidine enhanced the increase in urine flow and urea concentration elicited by hypobaric breathing without change in urinary creatinine level. By contrast, in Brattleboro diabetes insipidus rats, clonidine reinforced the hypoxia-induced mechanisms: oliguria, decrease in both urinary urea and creatinine excretions. During normobaric and hypobaric conditions in normal rats administration of clonidine induced an increase in electrolytes (Na+, K+, Cl-) excretion. In Brattleboro rats, clonidine potentiated the decrease in electrolytes excretion elicited by the hypobaric pressure breathing. Since the diuretic reflex elicited by the hypobaric pressure breathing is due to an inhibition of vasopressin release, the present data show that clonidine induces an inhibition of vasopressin release. However, it is suggested that beside this property clonidine also possesses direct vasoconstrictor actions during hypobaric pressure breathing.
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PMID:Renal effect of clonidine during acute hypobaric pressure breathing in normal and diabetes insipidus rats. 649 1

A 43-year-old man, with a history of central diabetes insipidus diagnosed 3 years previously, complained about reduced libido. An MRI scan showed a suprasellar lesion just below the supraoptic recess of the third ventricle. A stereotactically guided biopsy revealed fibrous glia, but no other specific tissue and no inflammatory cells. Two months later the patient presented with fatigue and muscular weakness. Tertiary adrenal failure and hypothyroidism were diagnosed by endocrine function tests and therapy with levothyroxine and hydrocortisone was started. Another 2 months later the patient was admitted with giddiness, nausea, peripheral oedema and oliguria. Radiological imaging and an open transperitoneal kidney exploration showed severe fibrosis around both ureters. Histological examination confirmed the diagnosis of idiopathic retroperitoneal fibrosis. Presumably the suprasellar tumour was the first manifestation of retroperitoneal fibrosis. Once the diagnosis 'idiopathic retroperitoneal fibrosis' is confirmed, fibrotic manifestations and complications involving extra-retroperitoneal tissues including the endocrine system, should be sought.
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PMID:Panhypopituitarism associated with severe retroperitoneal fibrosis. 1120 44

Transplantation has been incorporated into the treatment of patients with end-stage diseases of most major organ systems in recent years. However, organ supply is the greatest limitation to organ transplantation. Among the factors that can enhance organ supply, donor management has received the least attention. The importance of establishing an acceptable method of rapidly and accurately determining brain death in potential donors cannot be overemphasized. With an increased awareness of donor management issues and the application of a rational physiological approach, the supply of functional organs for transplantation can be increased. Rapid and continuing resuscitation of clinically brain-dead trauma victims is mandatory. This review addresses the evaluation and management of the organ donor within the emergency department. Common management problems (hypotension, arrhythmias, diabetes insipidus, oliguria, and coagulopathy) are discussed in detail. An aggressive, proactive approach to the medical management of the potential donor is recommended in order to limit the number of medical failures and maximize the number of organs donated.
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PMID:The brain-dead patient or a flower in the vase? The emergency department approach to the preservation of the organ donor. 1263 64


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