Endocrine Abstracts

Context: Postoperative central diabetes insipidus (PDI) is one of the most common complications of surgical treatment of pituitary adenoma, temporary or permanant. The diagnosis of PDI was suspicious in some occasions and inappropriate prescription of antidiuretic hormone was harmful. Generally, high level serum uric acid (HUA) was a clue for central diabetes insipidus, but we did not know its role for the brain postoperative subjects. As we know, the food intake and health condition was unstable during the acute short period after operation.

Objective: To explore whether HUA could be an indicator of PDI for those hospilized patients shortly after surgery of pituitary adenoma.

Design and patients: A total of 125 patients received resection of pituitary adenoma with pathologically diagnosed pituitary adenoma in the First Affiliated Hospital of Sun Yat-sen University from November 2017 to June 2019. A retrospective analysis of case records was done. General demographic information, daily lifestyle, anthropometric data and laboratory tests results were collected from case records. Excluding subjects without postoperative serum uric acid measurement, 43 individuals were included in the final analyses. HUA was defined as postoperative uric acid > 297.5 µmol/L (5 mg/dl). PDI was defined as postoperative urine volume > 4000 ml/24 h or being administrated of desmopressin such as Minirin post operation and prior to discharge. The relationship between PDI and HUA in these patients was analysed with Logistic regression analysis.

Results: The incidence of PDI in this study was 65.1%. The incidence of PDI in patients with postoperative HUA is 75.9% while it was 42.9% in patients without HUA (P = 0.046). Logistic regression analysis result showed that PDI was a significant factor for HUA. After adjusting for gender, age, the history of hypertension, diabetes mellitus, smoking and drinking, patients with PDI had increased risk of HUA (Odds Ratio (OR) = 12.13, 95% Confidence interval (CI): 1.03–142.29) (P = 0.047).

Conclusion: PDI was a very commom complication of the pituitary adenoma surgery. PDI was associated with HUA in the patients shortly after pituitary adenoma surgery.. Postoperative HUA might be an indicator of central diabetes insipidus in these patients. The limitation here was PDI might contain other reasons of polyurea, such as excessive fluid infusion. Further well designed prospective studies are needed.