Prognosis

Outcome and outlook depend on the underlying aetiology of AVP-D or AVP-R, and associated comorbidities. While AVP-D or AVP-R are often lifelong conditions, AVP-D following pituitary surgery or traumatic brain injury may be transient.​[3]​ AVP-R secondary to hypercalcaemia or hypokalaemia commonly resolves following treatment of the underlying electrolyte disorder.[5] While AVP-R secondary to medication may resolve following drug discontinuation, this is often not the case in those with AVP-R secondary to lithium.[41][64]​ AVP-D developing in pregnancy typically resolves following delivery.​

The majority of patients with chronic AVP-D are well controlled on the synthetic, long-acting arginine vasopressin (AVP) analogue desmopressin (also known as DDAVP). Patients require lifelong follow-up for any associated intracranial pathology that may have caused the AVP-D. Other anterior pituitary hormone replacement therapy must be monitored.

In patients with inherited AVP receptor pathway mutations and AVP-R, increased risks of hypernatraemia and other comorbidities have been noted. Optimal treatment can reduce the incidence of these complications.[65]

Patients with large-volume polyuria will need regular renal or bladder imaging, to avoid occult bladder or renal tract abnormalities such as hydronephrosis and bladder dysfunction.[66]

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