Care discontinuity and clinical decompensation in congenital central diabetes insipidus: Implications for management in primary care — a case report
DOI:
https://doi.org/10.33448/rsd-v15i4.50860Keywords:
Diabetes Insipidus, Primary Health Care, Continuity of Patient Care.Abstract
This study aims to describe the follow-up of a young adult with congenital central diabetes insipidus, emphasizing the relationship between discontinuity of care and clinical decompensation, as well as its implications for management in Primary Health Care. This is a descriptive study with a qualitative approach, conducted as a case report. Congenital central diabetes insipidus is a rare condition whose clinical stability depends on continuous long-term follow-up, and its interruption is associated with loss of hydroelectrolyte balance and preventable decompensation. We report the case of a 28-year-old man diagnosed in childhood through a water deprivation test with a positive response to desmopressin, who discontinued follow-up at the age of 15 and subsequently used the medication irregularly. He developed severe polyuria, persistent nocturia, fatigue, and progressive functional impairment, seeking primary care due to sustained elevated blood pressure. At reassessment, he presented a urine output of 12,800 mL/24 h, serum sodium of 147 mEq/L, and urine specific gravity of 1.003, with preserved renal function. The regular reintroduction of desmopressin, combined with antihypertensive therapy and reorganization of care, led to clinical and laboratory normalization. This case demonstrates that, even in rare conditions, continuity of care in Primary Health Care is a key determinant of clinical outcomes.
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Copyright (c) 2026 Caio Willer Brito Gonçalves, Helioenai Trajano Santos Costa, Matheus Majoel Henrique Silva, Gilberto Melo Ramos Filho, Gabriel Amaral Soares, Pablo Vitor Almeida de Brito, Paulo Luiz Almeida de Brito
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