{"id":"https://openalex.org/W4415474381","doi":"https://doi.org/10.1681/asn.202595e08y9z","title":"Triphasic Diabetes Insipidus: A Challenging Case of Severe Syndrome of Inappropriate Antidiuretic Hormone Secretion After Traumatic Brain Injury","display_name":"Triphasic Diabetes Insipidus: A Challenging Case of Severe Syndrome of Inappropriate Antidiuretic Hormone Secretion After Traumatic Brain Injury","publication_year":2025,"publication_date":"2025-10-01","ids":{"openalex":"https://openalex.org/W4415474381","doi":"https://doi.org/10.1681/asn.202595e08y9z"},"language":"en","primary_location":{"id":"doi:10.1681/asn.202595e08y9z","doi":"https://doi.org/10.1681/asn.202595e08y9z","is_oa":false,"landing_page_url":"https://doi.org/10.1681/asn.202595e08y9z","pdf_url":null,"source":{"id":"https://openalex.org/S115693375","display_name":"Journal of the American Society of Nephrology","issn_l":"1046-6673","issn":["1046-6673","1533-3450"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315620","host_organization_name":"American Society of Nephrology","host_organization_lineage":["https://openalex.org/P4310315620"],"host_organization_lineage_names":["American Society of Nephrology"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Society of Nephrology","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5040194125","display_name":"CZARINA TEANO","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210134211","display_name":"University of Virginia Medical Center","ror":"https://ror.org/046kb4y45","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2799765794","https://openalex.org/I4210134211"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Czarina Teano Faldu","raw_affiliation_strings":["UVA Health, Charlottesville, Virginia, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"UVA Health, Charlottesville, Virginia, United States;","institution_ids":["https://openalex.org/I4210134211"]}]},{"author_position":"middle","author":{"id":null,"display_name":"Susanna D'Silva","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I51556381","display_name":"University of Virginia","ror":"https://ror.org/0153tk833","country_code":"US","type":"education","lineage":["https://openalex.org/I51556381"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Susanna D'Silva","raw_affiliation_strings":["University of Virginia, Charlottesville, Virginia, United States"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Virginia, Charlottesville, Virginia, United States","institution_ids":["https://openalex.org/I51556381"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5093396636","display_name":"Geoffrey Nasuti","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210134211","display_name":"University of Virginia Medical Center","ror":"https://ror.org/046kb4y45","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2799765794","https://openalex.org/I4210134211"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Geoffrey Nasuti","raw_affiliation_strings":["UVA Health, Charlottesville, Virginia, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"UVA Health, Charlottesville, Virginia, United States;","institution_ids":["https://openalex.org/I4210134211"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5043847672","display_name":"Mark Douglas Okusa","orcid":"https://orcid.org/0000-0002-0801-0532","observed_orcids":["https://orcid.org/0000-0002-0801-0532"]},"institutions":[{"id":"https://openalex.org/I4210134211","display_name":"University of Virginia Medical Center","ror":"https://ror.org/046kb4y45","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2799765794","https://openalex.org/I4210134211"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Mark D. Okusa","raw_affiliation_strings":["UVA Health, Charlottesville, Virginia, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"UVA Health, Charlottesville, Virginia, United States;","institution_ids":["https://openalex.org/I4210134211"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5004415817","display_name":"Tushar Chopra","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210134211","display_name":"University of Virginia Medical Center","ror":"https://ror.org/046kb4y45","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2799765794","https://openalex.org/I4210134211"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Tushar Chopra","raw_affiliation_strings":["UVA Health, Charlottesville, Virginia, United States;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"UVA Health, Charlottesville, Virginia, United States;","institution_ids":["https://openalex.org/I4210134211"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.34223697,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"36","issue":"10S","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11967","display_name":"Electrolyte and hormonal disorders","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11967","display_name":"Electrolyte and hormonal disorders","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10706","display_name":"Traumatic Brain Injury and Neurovascular Disturbances","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10832","display_name":"Pituitary Gland Disorders and Treatments","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/central-diabetes-insipidus","display_name":"central diabetes insipidus","score":0.9940000176429749},{"id":"https://openalex.org/keywords/syndrome-of-inappropriate-antidiuretic-hormone-secretion","display_name":"syndrome of inappropriate antidiuretic hormone secretion","score":0.9259999990463257},{"id":"https://openalex.org/keywords/traumatic-brain-injury","display_name":"traumatic brain injury","score":0.9900000095367432},{"id":"https://openalex.org/keywords/hypernatremia","display_name":"hypernatremia","score":0.9760000109672546},{"id":"https://openalex.org/keywords/desmopressin","display_name":"desmopressin","score":0.9390000104904175},{"id":"https://openalex.org/keywords/urine-osmolality","display_name":"urine osmolality","score":0.8379999995231628},{"id":"https://openalex.org/keywords/water-balance","display_name":"water balance","score":0.6269999742507935},{"id":"https://openalex.org/keywords/cranioplasty","display_name":"cranioplasty","score":0.8429999947547913},{"id":"https://openalex.org/keywords/hypertonic-saline","display_name":"hypertonic saline","score":0.7429999709129333},{"id":"https://openalex.org/keywords/furosemide","display_name":"furosemide","score":0.9950000047683716},{"id":"https://openalex.org/keywords/traffic-accidents","display_name":"traffic accidents","score":0.4690000116825104},{"id":"https://openalex.org/keywords/osmotic-demyelination-syndrome","display_name":"central pontine myelinolysis","score":0.628000020980835}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8353999853134155},{"id":"https://openalex.org/C2781017439","wikidata":"https://www.wikidata.org/wiki/Q1995526","display_name":"Traumatic brain injury","level":2,"score":0.7555999755859375},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.7002999782562256},{"id":"https://openalex.org/C2779420931","wikidata":"https://www.wikidata.org/wiki/Q4774696","display_name":"Antidiuretic","level":3,"score":0.5631999969482422},{"id":"https://openalex.org/C134018914","wikidata":"https://www.wikidata.org/wiki/Q162606","display_name":"Endocrinology","level":1,"score":0.5444999933242798},{"id":"https://openalex.org/C555293320","wikidata":"https://www.wikidata.org/wiki/Q12206","display_name":"Diabetes mellitus","level":2,"score":0.5205000042915344},{"id":"https://openalex.org/C2778983183","wikidata":"https://www.wikidata.org/wiki/Q959457","display_name":"Syndrome of inappropriate antidiuretic hormone secretion","level":4,"score":0.4372999966144562},{"id":"https://openalex.org/C71315377","wikidata":"https://www.wikidata.org/wiki/Q11364","display_name":"Hormone","level":2,"score":0.36809998750686646},{"id":"https://openalex.org/C10162356","wikidata":"https://www.wikidata.org/wiki/Q1135939","display_name":"Pathophysiology","level":2,"score":0.35420000553131104},{"id":"https://openalex.org/C49039625","wikidata":"https://www.wikidata.org/wiki/Q84230","display_name":"Secretion","level":2,"score":0.33649998903274536},{"id":"https://openalex.org/C2776958162","wikidata":"https://www.wikidata.org/wiki/Q220551","display_name":"Diabetes insipidus","level":2,"score":0.31949999928474426},{"id":"https://openalex.org/C81182388","wikidata":"https://www.wikidata.org/wiki/Q353963","display_name":"Complication","level":2,"score":0.2639000117778778},{"id":"https://openalex.org/C2777180221","wikidata":"https://www.wikidata.org/wiki/Q3025883","display_name":"Type 2 diabetes","level":3,"score":0.2630999982357025},{"id":"https://openalex.org/C2991844318","wikidata":"https://www.wikidata.org/wiki/Q476921","display_name":"Renal injury","level":3,"score":0.25360000133514404},{"id":"https://openalex.org/C2778653478","wikidata":"https://www.wikidata.org/wiki/Q1054718","display_name":"Kidney disease","level":2,"score":0.25099998712539673}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1681/asn.202595e08y9z","doi":"https://doi.org/10.1681/asn.202595e08y9z","is_oa":false,"landing_page_url":"https://doi.org/10.1681/asn.202595e08y9z","pdf_url":null,"source":{"id":"https://openalex.org/S115693375","display_name":"Journal of the American Society of Nephrology","issn_l":"1046-6673","issn":["1046-6673","1533-3450"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315620","host_organization_name":"American Society of Nephrology","host_organization_lineage":["https://openalex.org/P4310315620"],"host_organization_lineage_names":["American Society of Nephrology"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Society of Nephrology","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4411121276","https://openalex.org/W4392792152","https://openalex.org/W3023789734","https://openalex.org/W3033600826","https://openalex.org/W4387405314","https://openalex.org/W4414313042","https://openalex.org/W4353107001","https://openalex.org/W2173231450","https://openalex.org/W4391661272","https://openalex.org/W2137669373"],"abstract_inverted_index":{"Introduction:":[0],"Central":[1],"diabetes":[2],"insipidus":[3],"(CDI)":[4],"is":[5,24,37],"a":[6,25,45,62,69,82,85,99,139,172,199,216,228,258],"known":[7],"complication":[8],"of":[9,20,31,47,65,102,108,126,142,158,175,219,253,262,276,282,285,311,319],"traumatic":[10],"brain":[11],"injuries":[12],"(TBI)":[13],"which":[14,41,154,239],"can":[15,288,304],"result":[16,289],"in":[17,110,156,168,290,294],"severe":[18,66],"cases":[19],"hypernatremia.":[21],"Triphasic":[22],"DI":[23,40,263,287],"rare":[26],"entity":[27],"with":[28,52,68,98,123,138,171,198,273],"an":[29],"incidence":[30],"only":[32],"1.1%.":[33],"The":[34,280],"first":[35],"phase":[36,55],"characterized":[38],"by":[39],"then":[42],"transforms":[43],"into":[44],"syndrome":[46],"inappropriate":[48],"antidiuretic":[49],"hormone":[50],"(SIADH)":[51],"the":[53,124,210,223,250,283,300,320],"third":[54],"resorting":[56],"back":[57],"to":[58,92,128,133,203,214,233,243,267],"DI.":[59],"We":[60],"present":[61],"challenging":[63],"case":[64,298],"SIADH":[67],"urine":[70,100,109,140,162,173,205,217,268],"osmolality":[71,101,141,174,218,323],"above":[72],"1200":[73],"mOsm/kg.":[74,144],"Case":[75],"Description:":[76],"A":[77],"26-year-old":[78],"female":[79],"presents":[80],"after":[81],"TBI":[83],"from":[84,316],"motor":[86],"vehicle":[87],"crash.":[88],"She":[89,113],"developed":[90],"hypernatremia":[91],"156":[93],"mmol/L":[94],"on":[95,116,135,178,249],"Day":[96,136,160,179,208],"2,":[97],"112":[103],"mOsm/kg":[104,177,221],"and":[105,150,183,187,246,269,278,314,324],"4,210":[106],"cc":[107],"24":[111,169],"hours.":[112],"was":[114,146,189,212,231,240,247],"initiated":[115],"desmopressin":[117],"(DDAVP)":[118],"1":[119,192],"mcg":[120,193,235,255],"twice":[121,195,237,257],"daily":[122,196],"improvement":[125,157],"sodium":[127,326],"normonatremia.":[129],"Sodium":[130],"levels":[131],"began":[132],"decline":[134],"6":[137],"1,188":[143],"DDAVP":[145,188,230],"held,":[147],"hypertonic":[148],"saline":[149,182],"furosemide":[151,184],"were":[152,185],"given,":[153],"resulted":[155],"sodium.":[159],"9,":[161],"output":[163],"increased,":[164],"reaching":[165],"11,975":[166],"mL":[167],"hours":[170],"78":[176],"10.":[180],"Hypertonic":[181],"stopped":[186],"restarted":[190],"at":[191],"IV":[194,236],"along":[197,272],"D5W":[200],"fluid":[201],"rate":[202],"match":[204],"output.":[206],"On":[207],"12,":[209],"patient":[211],"noted":[213],"have":[215],"1219":[220],"\u2013":[222],"same":[224,251],"day":[225],"she":[226],"underwent":[227],"cranioplasty.":[229],"reduced":[232],"0.5":[234],"daily,":[238],"later":[241],"switched":[242],"po":[244,256],"formulation":[245],"discharged":[248],"regimen":[252],"50":[254],"day.":[259],"Discussion:":[260],"Management":[261],"involves":[264],"critical":[265],"attention":[266],"serum":[270,325],"osmolalities":[271],"accurate":[274],"measurement":[275],"intake":[277],"outputs.":[279],"unpredictability":[281],"development":[284],"triphasic":[286],"rapid":[291],"life-threatening":[292],"fluctuations":[293],"water":[295],"balance.":[296],"This":[297],"exemplifies":[299],"dynamic":[301],"changes":[302],"that":[303],"occur":[305],"within":[306],"hours,":[307],"prompting":[308],"careful":[309],"monitoring":[310],"lab":[312],"values":[313],"symptoms":[315],"all":[317],"members":[318],"multidisciplinary":[321],"team.Urine":[322],"during":[327],"hospitalization.":[328]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2025-10-23T00:00:00"}