Aquaporins and the surgeon: cautionary tales

Nephrogenic diabetes insipidus (NDI) presents an uncommon but formidable cl inical challenge in the surgical patient. Two recent cases of NDI with diff ering aetiology are presented. These cases and a review of the literature i llustrate well the diagnosis, fluid and electrolyte imbalances seen and the strategy of treatment required in the post-operative setting. The central role of the recently discovered aquaporin channels in this condition is bri efly outlined. Nephrogenic diabetes insipidus has a diverse aetiology and m any of the hazards of the condition are peculiar to the surgical setting. T he importance of management in a high dependency environment is highlighted .