Dexmedetomidine-Associated Polyuria Mimicking Diabetes Insipidus

Area of Science:

• Critical Care Medicine
• Pharmacology
• Nephrology

Background:

• Dexmedetomidine is a selective α2-adrenergic agonist used for ICU sedation.
• Common side effects include hypotension and bradycardia.
• Rarely, it can cause polyuria resembling diabetes insipidus, particularly with prolonged use.

Purpose of the Study:

• To report a case of profound polyuria associated with dexmedetomidine infusion.
• To highlight an underrecognized adverse effect of dexmedetomidine.

Main Methods:

• Case report of a 53-year-old male with alcohol withdrawal.
• Dexmedetomidine infusion for 5 days.
• Monitoring of urine output, renal function, and electrolytes.
• Exclusion of other causes of polyuria.

Main Results:

• Patient developed profound polyuria (up to 6.75 L/day).
• Extensive workup ruled out other causes of polyuria.
• Polyuria resolved after dexmedetomidine discontinuation.
• Naranjo score indicated a probable association.

Conclusions:

• Dexmedetomidine can rarely cause polyuria mimicking central diabetes insipidus, especially beyond 24 hours.
• Early recognition prevents unnecessary diagnostics and complications like volume depletion.
• Close monitoring of urine output and electrolytes is vital during extended dexmedetomidine infusions.