Nephrogenic Diabetes Insipidus is a Rare Complication of Chronic Kidney Disease - A Case Report TAHMINA JESMIN1, MD. HABIBUR RAHMAN2, GOALM MUINUDDIN3, AFROZA BEGUM4,

Nephrogenic Diabetes Insipidus (NDI) may occur as a complication of chronic kidney disease (CKD). The incidence of NDI is very rare. So recognition of this potential complication is very important. In our country, this rare complication is not yet reported. So, to make awareness among the paediatricians, we report a case of NDI as a rare complication of CKD. A 4-year old boy was admitted in the Department of Paediatric Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU) with the complaints of failure to thrive, refusal to feed, nausea and vomiting since 18months of his age. For the last six months, he had also complaints of polyuria and polydipsia. In addition to this, he developed muscle pain, constipation, bowing of leg and occasional unexplained fever. He was moderately pale with deep sighing respiration and his blood pressure was above 95th centile for age and sex. His creatinine level was high with low TCO2 and calcium level. His plasma osmolality was very high while urine osmolality was inappropriately low which did not increase after desmopressin (nasal spray) administration. Initial treatment with Indomethacin was ineffective while the combination of hydrochlorothiazide and Indomethacin was effective and well tolerated. 1. Resident Phase B, Paediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka. 2. Professor of Paediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka. 3. Professor and Chairman of Paediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka. 4. Associate Professor of Paediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka. 5. Associate Professor of Paediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka. 6. Professor of Paediatric Nephrolog, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka. Correspondence: Dr. Tahmina Jesmin, Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Email: tahmina.jesmin@ yahoo.com infection, obstructive uropathy, hypoplastic or dysplastic kidneys etc. In our continent, GN is reported as the main cause of CKD2. These patients have various medical (renal ostedystrophy, anaemia, growth retardation, raised blood pressure) and psychosocial problems. Secondary Nephrogenic Diabetes Insipidus (NDI) may occur as a complication of CKD3. The recognition of this potential complication is very important. The incidence of NDI is very rare. The recent estimate of prevalence of NDI in Canada is 8.8: 1000000 in male4 In our country, CKD patients with rare complication of NDI is yet to report for making awareness among the Paediatricians. So, we are reporting here a child who presented with NDI as a complication of CKD. Initially polyuria, polydipsia were not prominent in this particular patient rather he had history of failure to thrive, vomiting and convulsion.