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MONDAY, Aug. 6, 2018 (HealthDay News) — In patients with hypotonic polyuria, the direct measurement of hypertonic saline-stimulated plasma copeptin has better diagnostic accuracy than the water-deprivation test, according to a study published in the Aug. 2 issue of the New England Journal of Medicine<\/i>.<\/p>\n
Wiebke Fenske, M.D., Ph.D., from the University of Leipzig in Germany, and colleagues compared the indirect water-deprivation test with direct detection of plasma copeptin among 144 patients with hypotonic polyuria at 11 medical centers who underwent both tests.<\/p>\n
The researchers found that the indirect water-deprivation test determined the correct diagnosis in 108 of the 141 patients included in the analysis (diagnostic accuracy, 76.6 percent), while the hypertonic saline infusion test (with a copeptin cutoff level of >4.9 pmol per liter) determined the correct diagnosis in 136 patients (96.5 percent). Primary polydipsia was distinguished from partial central diabetes insipidus with the indirect water-deprivation test in 77 of 105 patients (73.3 percent), compared to 99 of 104 patients (95.2 percent) with the hypertonic saline infusion. One serious adverse event (desmopressin-induced hyponatremia), which required hospitalization, occurred during the water-deprivation test.<\/p>\n
“This prospective evaluation of patients with hypotonic polyuria validated hypertonic saline-stimulated copeptin measurement as a diagnostic method that appeared to be superior to the indirect water-deprivation test in distinguishing central diabetes insipidus from primary polydipsia,” the authors write.<\/p>\n
Several authors disclosed financial ties to pharmaceutical and medical device companies, including Thermo Fisher Scientific, which funded laboratory measurement of copeptin.<\/p>\n
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