Central diabetes insipidus (vasopressin deficiency) after surgery for pituitary tumours: a systematic review and meta-analysis
Authors' conclusion
Following TSS, a small proportion of patients with pituitary adenoma have permanent AVP-D (2%), but prevalence reaches 30% in ones with craniopharyngioma and 14% in those with RCC. Diagnostic criteria for post-operative AVP-D remain variable affecting reported rates of this condition.
Study context
- Population
- Patients with pituitary adenoma, craniopharyngioma or Rathke's cleft cyst (RCC) treated with transsphenoidal surgery (TSS); studies 2000–2021 providing a definition of post-operative AVP-D51 studies
- Comparison
- Pituitary adenoma vs Craniopharyngioma vs RCC
- Outcome
- Rates of newly developed transient or permanent AVP-D after TSS
Methodological detailsrandom effects meta-analysis, Freeman-Tukey transformation, Medline, Embase and Cochrane Library searched, January 1, 2000 to January 31, 2021; 51 of 11 694 studies included
- Random effects meta-analysis
- Freeman-Tukey transformation
- Medline, Embase and Cochrane Library searched, January 1, 2000 to January 31, 2021; 51 of 11 694 studies included
Pooled result
As reported in the abstract
Transient / permanent AVP-D (pooled proportion)
- Total: transient AVP-D
- 17% (95% CI, 13-21)
- Total: permanent AVP-D
- 3% (95% CI, 2-5)
- Pituitary adenoma: transient AVP-D
- 16% (95% CI, 12-21)
- Pituitary adenoma: permanent AVP-D
- 2% (95% CI, 2-3)
- Craniopharyngioma: transient AVP-D
- 31% (95% CI, 24-39)
- Craniopharyngioma: permanent AVP-D
- 30% (95% CI, 22-39)
- RCC: transient AVP-D
- 35% (95% CI, 16-57)
- RCC: permanent AVP-D
- 14% (95% CI, 6-23)
Further pooled results
Transient / permanent AVP-D by diagnostic criteria
- Hypotonic polyuria: transient AVP-D
- 14% (95% CI, 8-22)
- Hypotonic polyuria: permanent AVP-D
- 3% (95% CI, 1-4)
- Hypotonic polyuria and hypernatraemia: transient AVP-D
- 21% (95% CI, 13-29)
- Hypotonic polyuria and hypernatraemia: permanent AVP-D
- 5% (95% CI, 2-11)
- Desmopressin administration: transient AVP-D
- 22% (95% CI, 15-29)
- Desmopressin administration: permanent AVP-D
- 9% (95% CI, 0-30)
Original publication
Central diabetes insipidus (vasopressin deficiency) after surgery for pituitary tumours: a systematic review and meta-analysis. Eur J Endocrinol. Published 12 July 2024. doi:10.
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