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Hypertensive urgency in nephrogenic diabetes insipidus with concomitant Hinman syndrome
  1. Yu Guang Tan1,2,
  2. Daniel Wei Keong Chan3,
  3. Fabian Kok Peng Yap3 and
  4. Te-Lu Yap2
  1. 1 Urology, Singapore General Hospital, Singapore
  2. 2 Paediatrics Surgery, KK Women’s and Children’s Hospital, Singapore
  3. 3 Paediatrics, KK Women’s and Children’s Hospital, Singapore
  1. Correspondence to Dr Yu Guang Tan, yuguangtan90{at}


Diabetes insipidus is a syndrome characterised by the inability to conserve water or concentrate urine, leading to excessive excretion of urine. In congenital nephrogenic diabetes insipidus (CNDI), common presentations include failure to thrive, polydipsia, polyuria and dehydration. The long trajectory of the disease, coupled with psycho-behavioural changes as a child grows, can precipitate a period of non-adherence despite initial optimal control, especially in the adolescent age group. Social inconvenience of repeated voiding and nocturnal disturbances can lead to adapted urine holding behaviour, also known as non-neurogenic neurogenic bladder (Hinman syndrome). Anatomical changes in the urinary system, such as bladder trabeculation and hydroureteronephrosis, can subsequently give rise to functional renal impairment. We present a case of CNDI with concomitant Hinman syndrome, resulting in acute renal impairment and hypertensive emergency. We aim to raise awareness of the association between these two entities.

  • paediatrics
  • urology
  • endocrinology
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  • Contributors YGT contributed in the conduct and reporting, data acquisition, data interpretation, writing and revision of manuscript. DWKC contributed in the data acquisition, writing and revision of manuscript. FKPY contributed to the concept and design and the revision of the manuscript. T-LY contributed to the concept and design and revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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