AMELIORATION OF POLYURIA BY AMILORIDE IN PATIENTS RECEIVING LONG-TERM LITHIUM-THERAPY
AMELIORATION OF POLYURIA BY AMILORIDE IN PATIENTS RECEIVING LONG-TERM LITHIUM-THERAPY
复制标题
DOI：
10.1056/nejm198502143120705
复制
发表时间：
1985-01-01
影响因子：
158.5
通讯作者：
GRUPP, M
中科院分区：
文献类型：
--
作者：
BATLLE, DC;VONRIOTTE, AB;GRUPP, M
Vasopressin-resistant diabetes insipidus is a common side effect of the treatment of affective disorders with Li. The effect of amiloride on Li-induced polyuria in 9 such patients receiving maintenance Li therapy who had a vasopressin-resistant defect in urinary concentrating ability was studied. After a mean (.+-. SE) of 24 .+-. 6 days of amiloride administration, the urine volume fell (from 4.7 .+-. 0.6 to 3.1 .+-. 0.3 l /24 h; P < 0.005) and the urine osmolality increased (from 228 .+-. 35 to 331 .+-. 34 mOsm/kg of H2O;P < 0.001). The decrease in urine output was sustained during 6 mo. of observation in the absence of any significant change in plasma levels of Li, K or bicarbonate; urinary excretion of Na or Li; or creatinine clearance. Amiloride administration was also assocated with a significant increase in urine osmolality (from 575 .+-. 54 to 699 .+-. 48 mOsm/kg of H2O; P < 0.005) measured after fluid deprivation and the injection of exogenous vasopressin. Amiloride mitigates Li-induced polyuria, at least partly, by blunting the inhibitory effect of Li on water transport in the renal collecting tubule. Amiloride may provide a specific therapy for polyuria in Li-treated patients, while obviating the need for K supplementation in the treatment of this kind of polyuria.
