{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T14:05:03Z","timestamp":1775570703305,"version":"3.50.1"},"reference-count":7,"publisher":"SMC Media","issue":"3","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Dexmedetomidine is a highly selective alpha-2-adrenergic agonist widely used for sedation in the intensive care unit (ICU) and is generally considered well tolerated, with hypotension and bradycardia being the most commonly reported adverse effects. Rarely, dexmedetomidine has been associated with polyuria resembling a diabetes insipidus-like syndrome, particularly during prolonged infusions. We report the case of a 53-year-old male admitted to the ICU for severe alcohol withdrawal who developed profound polyuria during a 5-day dexmedetomidine infusion. Urine output progressively increased to 6.75 litres per day, prompting an extensive evaluation that excluded osmotic diuresis, infection, intracranial pathology, and nephrogenic diabetes insipidus. Laboratory studies demonstrated preserved renal function and normal serum electrolytes. The temporal association between dexmedetomidine initiation and polyuria onset, along with resolution following drug discontinuation, supported the diagnosis of dexmedetomidine-associated polyuria, with a Naranjo adverse drug reaction probability score of 8 indicating a probable association. This case highlights an underrecognized adverse effect of dexmedetomidine. It underscores the importance of monitoring urine output and electrolytes during prolonged infusions to facilitate early recognition, prevent unnecessary diagnostic testing, and avoid complications related to volume depletion and electrolyte imbalance.<\/jats:p>","DOI":"10.12890\/2026_006195","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T15:21:13Z","timestamp":1771255273000},"source":"Crossref","is-referenced-by-count":1,"title":["Dexmedetomidine-associated polyuria mimicking diabetes insipidus"],"prefix":"10.12890","volume":"13","author":[{"given":"Sankalp","family":"Acharya","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Rutgers Monmouth Medical Center, Long Branch, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sai","family":"Shahane","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Rutgers Monmouth Medical Center, Long Branch, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanket","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, GMERS Civil Hospital Sola, Ahmedabad, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhruvil","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, GMERS Civil Hospital, Gandhinagar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vyoma","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Maimonides Medical Center, Brooklyn, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shailesh","family":"Aggarwal","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Rutgers Monmouth Medical Center, Long Branch, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hardikkumar","family":"Bhanderi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Rutgers Monmouth Medical Center, Long Branch, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"10.12890\/2026_006195_ref1","doi-asserted-by":"crossref","unstructured":"Keating GM. Dexmedetomidine: A Review of Its Use for Sedation in the Intensive Care Setting. Drugs 2015;75:1119-1130. doi: 10.1007\/s40265-015-0419-5","DOI":"10.1007\/s40265-015-0419-5"},{"key":"10.12890\/2026_006195_ref2","doi-asserted-by":"crossref","unstructured":"Pratt A, Aboudara M, Lung L. Case report: polyuria related to dexmedetomidine. Anesth Analg 2013;117:150-152. doi: 10.1213\/ANE.0b013e3182917c86","DOI":"10.1213\/ANE.0b013e3182917c86"},{"key":"10.12890\/2026_006195_ref3","doi-asserted-by":"crossref","unstructured":"Kramer MS, Leventhal JM, Hutchinson TA, Feinstein AR. An algorithm for the operational assessment of adverse drug reactions. I. Background, description, and instructions for use. JAMA 1979;242:623-632.","DOI":"10.1001\/jama.1979.03300070019017"},{"key":"10.12890\/2026_006195_ref4","doi-asserted-by":"crossref","unstructured":"Zhu J, Lu D, Liu JF. Intraoperative dexmedetomidine-related polyuria: A case report and review of the literature. Int J Clin Pharmacol Ther 2022;60:188-191. doi: 10.5414\/CP204129","DOI":"10.5414\/CP204129"},{"key":"10.12890\/2026_006195_ref5","doi-asserted-by":"crossref","unstructured":"Van Decar LM, Reynolds EG, Sharpe EE, Harbell MW, Kosiorek HE, Kraus MB. Perioperative Diabetes Insipidus Caused by Anesthetic Medications: A Review of the Literature. Anesth Analg 2022;134:82-89. doi: 10.1213\/ANE.0000000000005344","DOI":"10.1213\/ANE.0000000000005344"},{"key":"10.12890\/2026_006195_ref6","doi-asserted-by":"crossref","unstructured":"Greening A, Mathews L, Blair J. Apparent dexmedetomidine-induced polyuric syndrome in an achondroplastic patient undergoing posterior spinal fusion. Anesth Analg 2011;113:1381-1383. doi: 10.1213\/ANE.0b013e31823299c1","DOI":"10.1213\/ANE.0b013e31823299c1"},{"key":"10.12890\/2026_006195_ref7","doi-asserted-by":"crossref","unstructured":"Reynolds EG, Van Decar LM, Sharpe EE, Harbell MW, Kraus MB. Dexmedetomidine-associated diabetes insipidus during skull base surgery in a pediatric patient. Paediatr Anaesth 2023;33:250-253. doi: 10.1111\/pan.14587","DOI":"10.1111\/pan.14587"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/6195\/5109","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/6195\/5110","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/6195\/5110","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T15:07:33Z","timestamp":1772723253000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/6195"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,9]]},"references-count":7,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.12890\/2026_006195","relation":{"has-manifestation":[{"id-type":"other","id":"1-164-6195-g5109","asserted-by":"subject"},{"id-type":"other","id":"1-164-6195-g5110","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-164","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"value":"2284-2594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,9]]}}}