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Severe symptoms may include one or a combination of the following: seizure, coma and/or respiratory arrest [5]. Patients should be advised to contact a doctor immediately if they feel unwell or experience unusual [http://en.wikipedia.org/wiki/ADAMTS12 ADAMTS12] symptoms. In summary, these cases highlight the importance of appropriate fluid restriction and monitoring following administration of DDAVP prior to renal biopsy. To prevent recurrence of similar cases, we have altered our hospital policy to include the points listed below and have included information on the side effects of DDAVP in our renal biopsy patient information leaflet. Learning points Review sodium concentrations prior to administration of DDAVP and avoid DDAVP use if serum sodium is  in the first 24 h following DDAVP use, with advice to contact a doctor to have repeat serum sodium measurements. Funding This work received no grant from any funding agency in the public, commercial or not-for-profit [http://www.selleckchem.com/products/byl719.html Selleckchem Alpelisib] sectors. Conflict of interest statement The authors of this manuscript have no conflicts of interest and no involvements that might raise the question of bias in the work reported or in the conclusions, implications or opinions stated. The case reports presented in this paper have not been [http://www.selleckchem.com/products/SB-431542.html SB431542] published previously.""A 73-year-old Caucasian man with stage 3 CKD was admitted for worsening of renal function. Some weeks before he developed dyspepsia, anorexia, weight loss, asthenia and nocturia. He was initially accepted to another hospital and discharged with the diagnosis of stage 5 CKD. During this first hospitalization he declined the surgery to create an arteriovenous fistula (AVF) for haemodialysis and refused renal replacement therapy. The medical history revealed that he had hypertension and atrial fibrillation. Medications included pantoprazole, darbepoetin, bisoprolol and warfarin. Physical examination was substantially normal, BMI was 28 kg/m2 and blood pressure was 140/75 mmHg. Renal ultrasound demonstrated normal dimensions with preserved cortical thickness and no obstruction. Chest X-ray and abdominal CT scan were normal. The admission serum creatinine (sCr) was 6.96 mg/dL (eGFR 8 mL/min/1.73 m2), while 1 year before sCr was 1.3 mg/dL (eGFR 58 mL/min/1.73 m2). Urinalysis demonstrated significant proteinuria (2.46 g/24 h) and erythrocyturia (1739 RBC/?L). Serum albumin concentration was normal (4.1 g/dL) and a small monoclonal component (IgG k