Anaesthetic management in a paediatric patient with nephrogenic diabetes insipidus during hypospadias repair: A case report

Abstract

Nephrogenic diabetes insipidus (NDI) is a rare condition characterized by impaired renal responsiveness to antidiuretic hormone, leading to fluid and electrolyte imbalances. Perioperative management of paediatric patients with NDI presents significant challenges, especially in maintaining fluid and electrolyte homeostasis. This case report details the anaesthetic management of a 4-year-old boy with NDI undergoing hypospadias repair. The patient, weighing 13.5 kg, presented with polyuria and polydipsia, managed with hydrochlorothiazide. Preoperative investigations revealed normal serum electrolytes and partial renal responsiveness to antidiuretic hormone. The anaesthetic plan included general anaesthesia with intravenous ketamine and succinylcholine for induction, providing haemodynamic stability and minimal renal impact.