What is a major risk associated with administering desmopressin for diabetes insipidus?

Desmopressin is a synthetic analog of vasopressin (antidiuretic hormone) used primarily to treat central diabetes insipidus, a condition characterized by excessive thirst and urination due to insufficient vasopressin secretion. The major risk associated with administering desmopressin is fluid overload.

Fluid overload can occur because desmopressin increases water reabsorption in the kidneys, leading to reduced urine output. If fluid intake is not monitored or controlled, patients can retain excess fluid, which may result in an imbalance of electrolyte levels and increase the risk of hyponatremia (low sodium levels in the blood). This can manifest as symptoms like headache, confusion, and in severe cases, seizures or coma. Therefore, careful monitoring of fluid balance and sodium levels is crucial when administering desmopressin to prevent complications related to fluid overload.

In this context, potassium retention, hypoglycemia, and acidosis are not typically associated with desmopressin therapy. Instead, the primary focus is on the risk of fluid imbalance due to the medication's effect on water retention.