Diabetes Insipidus and Syndrome of Inappropriate Secretion of Antidiuretic Hormone in Children with Midline Suprasellar Brain Tumors

Abstract

Salt and water balance within the body is controlled by the hormonal influence of vasopressin. Vasopressin is produced in the hypothalamus, stored and released from the posterior lobe of the pituitary, and travels via the blood to the kidneys to regulate the amount and concentration of urine excreted. Oversecretion or undersecretion of vasopressin, eg, diabetes insipidus (DI) or syndrome of inappropriate secretion of antidiuretic hormone (SIADH) results in an imbalance of the salt-to-water ratio. In children this hormonal imbalance may occur secondary to a suprasellar brain tumor and/or the treatment of such. Approximately 50% to 75% of children with suprasellar tumors will develop permanent DI and the remainder will experience transient postoperative DI or SIADH. Pathophysiology of vasopressin's control on salt and water balance and its relationship to suprasellar brain tumors in children are presented. Nursing assessment and intervention parameters for management of DI and SIADH in children with brain tumors are also discussed.

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References

Bacon G. , Spencer M. , Hopwood N. , et al: Diabetes insipidus and inappropriate antidiuretic hormone secretion , in Bacon G (ed): A Practical Approach to Pediatric Endocrinology (ed 2). Chicago, IL, Yearbook Medical, 1982 , pp 252-261

Hershman J. : Disorders of water metabolism, in Bacon G (ed): Endocrine Pathophysiology: A Patient Oriented Approach. Malvem, PA, Lea & Febiger, 1988, pp 301-321

Hickey J. : The Clinical Practice of Neurological and Neurosurgical Nursing (ed 2). Philadelphia, PA, Lippincott, 1986

Hung W. , August G. , Glasgow G. : The posterior pituitary gland, in Pediatric Endocrinology. Medical Examination Publishing Co, Inc, 1983, pp 103-111

Raiti S. : Diabetes insipidus, in Litshitz M (ed): Pediatric Endocrinology. New York, NY, Dekker, 1985, pp 577-589

Shiminski-Maher T. , Rosenberg M. : Late effects associated with treatment of craniopharyngiomas in children. J Neurosci Nurs 22:220-226, 1990

Shucart W. , Jackson I. : Management of diabetes insipidus in neurosurgical patients. J Neurosurg 44:65-69, 1976 8. Sklar C. : Diabetes insipidus, in Zimmerman S, Gildea J (eds): Critical Care Pediatrics. Philadelphia, PA, Saunders, 1985 , pp 249-256

Sklar C. : Syndrome of inappropriate secretion of ADH, in Zimmerman S , Gildea J (eds): Critical Care Pediatrics. Philadelphia, PA, Saunders, 1985, pp 243-248