Use of copeptin in interpretation of the water deprivation test
Abstract Introduction Currently, the water deprivation test remains the standard method for distinguishing primary polydipsia (PP) from cranial diabetes insipidus (cDI) and nephrogenic diabetes insipidus (nDI). There is increasing interest in a direct estimate of antidiuretic hormone using plasma co...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-05-01
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| Series: | Endocrinology, Diabetes & Metabolism |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/edm2.399 |
| _version_ | 1797831814388121600 |
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| author | Matthew Rowe Nishchil Patel Jinny Jeffery Daniel Flanagan |
| author_facet | Matthew Rowe Nishchil Patel Jinny Jeffery Daniel Flanagan |
| author_sort | Matthew Rowe |
| collection | DOAJ |
| description | Abstract Introduction Currently, the water deprivation test remains the standard method for distinguishing primary polydipsia (PP) from cranial diabetes insipidus (cDI) and nephrogenic diabetes insipidus (nDI). There is increasing interest in a direct estimate of antidiuretic hormone using plasma copeptin as a stable and reliable surrogate marker. We present our experience of measuring copeptin during the water deprivation test. Methods Forty‐seven people (17 men) underwent a standard water deprivation test between 2013 and 2021. Plasma copeptin was measured at the start of the test and at the end of the period of water deprivation (maximum osmotic stimulation). Results were classified using prespecified diagnostic criteria. As it is known that a significant proportion of tests will reveal indeterminate results, a final diagnosis was obtained by including relevant pre‐ and post‐test clinical criteria. This diagnosis was then used to plan individual treatment. Results Basal and stimulated copeptin were significantly higher in the nephrogenic DI group than other categories (p < .001). There was no significant difference in basal or stimulated copeptin between PP, cDI or partial DI. Nine results were indeterminate where the serum and urine osmolality did not give a unified diagnosis. Stimulated copeptin was helpful in reclassifying these patients into the final diagnostic groups. Conclusion Plasma copeptin has additional clinical utility in interpretation of the water deprivation test and may continue to have a place alongside newer stimulation tests. |
| first_indexed | 2024-04-09T13:57:45Z |
| format | Article |
| id | doaj.art-5add0bd7a8554fd3a564447267e9140b |
| institution | Directory Open Access Journal |
| issn | 2398-9238 |
| language | English |
| last_indexed | 2024-04-09T13:57:45Z |
| publishDate | 2023-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Endocrinology, Diabetes & Metabolism |
| spelling | doaj.art-5add0bd7a8554fd3a564447267e9140b2023-05-07T18:25:43ZengWileyEndocrinology, Diabetes & Metabolism2398-92382023-05-0163n/an/a10.1002/edm2.399Use of copeptin in interpretation of the water deprivation testMatthew Rowe0Nishchil Patel1Jinny Jeffery2Daniel Flanagan3Department of Endocrinology University Hospital Plymouth Plymouth UKDepartment of Endocrinology University Hospital Plymouth Plymouth UKCombined Labs University Hospitals Plymouth Plymouth UKDepartment of Endocrinology University Hospital Plymouth Plymouth UKAbstract Introduction Currently, the water deprivation test remains the standard method for distinguishing primary polydipsia (PP) from cranial diabetes insipidus (cDI) and nephrogenic diabetes insipidus (nDI). There is increasing interest in a direct estimate of antidiuretic hormone using plasma copeptin as a stable and reliable surrogate marker. We present our experience of measuring copeptin during the water deprivation test. Methods Forty‐seven people (17 men) underwent a standard water deprivation test between 2013 and 2021. Plasma copeptin was measured at the start of the test and at the end of the period of water deprivation (maximum osmotic stimulation). Results were classified using prespecified diagnostic criteria. As it is known that a significant proportion of tests will reveal indeterminate results, a final diagnosis was obtained by including relevant pre‐ and post‐test clinical criteria. This diagnosis was then used to plan individual treatment. Results Basal and stimulated copeptin were significantly higher in the nephrogenic DI group than other categories (p < .001). There was no significant difference in basal or stimulated copeptin between PP, cDI or partial DI. Nine results were indeterminate where the serum and urine osmolality did not give a unified diagnosis. Stimulated copeptin was helpful in reclassifying these patients into the final diagnostic groups. Conclusion Plasma copeptin has additional clinical utility in interpretation of the water deprivation test and may continue to have a place alongside newer stimulation tests.https://doi.org/10.1002/edm2.399copeptin humandiabetes insipiduswater deprivation |
| spellingShingle | Matthew Rowe Nishchil Patel Jinny Jeffery Daniel Flanagan Use of copeptin in interpretation of the water deprivation test Endocrinology, Diabetes & Metabolism copeptin human diabetes insipidus water deprivation |
| title | Use of copeptin in interpretation of the water deprivation test |
| title_full | Use of copeptin in interpretation of the water deprivation test |
| title_fullStr | Use of copeptin in interpretation of the water deprivation test |
| title_full_unstemmed | Use of copeptin in interpretation of the water deprivation test |
| title_short | Use of copeptin in interpretation of the water deprivation test |
| title_sort | use of copeptin in interpretation of the water deprivation test |
| topic | copeptin human diabetes insipidus water deprivation |
| url | https://doi.org/10.1002/edm2.399 |
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