Diagnostic Accuracy of Copeptin in the Differential Diagnosis of the Polyuria-polydipsia Syndrome: A Prospective Multicenter Study.

Details

Serval ID
serval:BIB_5FE8794F4F04
Type
Article: article from journal or magazin.
Collection
Publications
Title
Diagnostic Accuracy of Copeptin in the Differential Diagnosis of the Polyuria-polydipsia Syndrome: A Prospective Multicenter Study.
Journal
The Journal of clinical endocrinology and metabolism
Author(s)
Timper K., Fenske W., Kühn F., Frech N., Arici B., Rutishauser J., Kopp P., Allolio B., Stettler C., Müller B., Katan M., Christ-Crain M.
ISSN
1945-7197 (Electronic)
ISSN-L
0021-972X
Publication state
Published
Issued date
06/2015
Peer-reviewed
Oui
Volume
100
Number
6
Pages
2268-2274
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
The polyuria-polydipsia syndrome comprises primary polydipsia (PP) and central and nephrogenic diabetes insipidus (DI). Correctly discriminating these entities is mandatory, given that inadequate treatment causes serious complications. The diagnostic "gold standard" is the water deprivation test with assessment of arginine vasopressin (AVP) activity. However, test interpretation and AVP measurement are challenging.
The objective was to evaluate the accuracy of copeptin, a stable peptide stoichiometrically cosecreted with AVP, in the differential diagnosis of polyuria-polydipsia syndrome.
This was a prospective multicenter observational cohort study from four Swiss or German tertiary referral centers of adults >18 years old with the history of polyuria and polydipsia.
A standardized combined water deprivation/3% saline infusion test was performed and terminated when serum sodium exceeded 147 mmol/L. Circulating copeptin and AVP levels were measured regularly throughout the test. Final diagnosis was based on the water deprivation/saline infusion test results, clinical information, and the treatment response.
Fifty-five patients were enrolled (11 with complete central DI, 16 with partial central DI, 18 with PP, and 10 with nephrogenic DI). Without prior thirsting, a single baseline copeptin level >21.4 pmol/L differentiated nephrogenic DI from other etiologies with a 100% sensitivity and specificity, rendering a water deprivation testing unnecessary in such cases. A stimulated copeptin >4.9 pmol/L (at sodium levels >147 mmol/L) differentiated between patients with PP and patients with partial central DI with a 94.0% specificity and a 94.4% sensitivity. A stimulated AVP >1.8 pg/mL differentiated between the same categories with a 93.0% specificity and a 83.0% sensitivity.
This study was limited by incorporation bias from including AVP levels as a diagnostic criterion.
Copeptin is a promising new tool in the differential diagnosis of the polyuria-polydipsia syndrome, and a valid surrogate marker for AVP. Primary Funding Sources: Swiss National Science Foundation, University of Basel.
Keywords
Adult, Arginine Vasopressin/blood, Cohort Studies, Diabetes Insipidus, Nephrogenic/blood, Diabetes Insipidus, Nephrogenic/complications, Diabetes Insipidus, Nephrogenic/diagnosis, Diabetes Insipidus, Neurogenic/blood, Diabetes Insipidus, Neurogenic/complications, Diabetes Insipidus, Neurogenic/diagnosis, Diagnosis, Differential, Female, Glycopeptides/blood, Humans, Male, Middle Aged, Polydipsia/blood, Polydipsia/complications, Polydipsia/diagnosis, Polyuria/blood, Polyuria/complications, Polyuria/diagnosis, Sensitivity and Specificity, Syndrome, Water Deprivation/physiology
Pubmed
Web of science
Create date
27/12/2020 22:41
Last modification date
28/12/2020 6:26
Usage data