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Ufer, Friederike; Diederich, Sven; Pedersen, Erling B.; Spranger, Joachim; Pfeiffer, Andreas F. H.; Bähr, Volker; Mai, Knut

Arginine vasopressin‐dependent and AVP‐independent mechanisms of renal fluid absorption during thirsting despite glucocorticoid‐mediated vasopressin suppression

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  • Media type: E-Article
  • Title: Arginine vasopressin‐dependent and AVP‐independent mechanisms of renal fluid absorption during thirsting despite glucocorticoid‐mediated vasopressin suppression
  • Contributor: Ufer, Friederike; Diederich, Sven; Pedersen, Erling B.; Spranger, Joachim; Pfeiffer, Andreas F. H.; Bähr, Volker; Mai, Knut
  • imprint: Wiley, 2013
  • Published in: Clinical Endocrinology
  • Language: English
  • DOI: 10.1111/cen.12006
  • ISSN: 1365-2265; 0300-0664
  • Origination:
  • Footnote:
  • Description: <jats:title>Summary</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>Glucocorticoids seem to modify the release and effects of plasma arginine vasopressin (p<jats:styled-content style="fixed-case">AVP</jats:styled-content>). However, underlying processes are not well understood. This study aimed to evaluate the mechanism of the modulating effects of glucocorticoids on p<jats:styled-content style="fixed-case">AVP</jats:styled-content> and renal water reabsorption.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Fluid deprivation tests were performed without (d0) and after one (d1) and five days (d5) of oral prednisolone (<jats:styled-content style="fixed-case">P</jats:styled-content>red) pretreatment in a dosage relevant to drug therapy (30 mg/day).</jats:p></jats:sec><jats:sec><jats:title>Patients</jats:title><jats:p>Twelve healthy male volunteers participated in this trial.</jats:p></jats:sec><jats:sec><jats:title>Measurements</jats:title><jats:p>Plasma and urinary osmolality, p<jats:styled-content style="fixed-case">AVP</jats:styled-content>, renin, aldosterone, plasma atrial natriuretic peptide (<jats:styled-content style="fixed-case">ANP</jats:styled-content>) as well as urinary secretion of aquaporin‐2 (<jats:styled-content style="fixed-case">AQP</jats:styled-content>2) and prostaglandin <jats:styled-content style="fixed-case">E</jats:styled-content><jats:sub>2</jats:sub> (<jats:styled-content style="fixed-case">PGE</jats:styled-content>2) were analysed.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>An appropriate rise in p<jats:styled-content style="fixed-case">AVP</jats:styled-content> was observable during thirsting (<jats:italic>P</jats:italic> &lt; 0·001), which was absent after <jats:styled-content style="fixed-case">P</jats:styled-content>red pretreatment. However, the plasma and urinary osmolality after <jats:styled-content style="fixed-case">P</jats:styled-content>red treatment did not differ when compared with the basal thirsting test. Unchanged urinary <jats:styled-content style="fixed-case">AQP</jats:styled-content>2 excretion suggests <jats:styled-content style="fixed-case">AVP</jats:styled-content>‐independent mechanisms of renal fluid reabsorption. Plasma renin concentration as well as <jats:styled-content style="fixed-case">ANP</jats:styled-content> was substantially increased after <jats:styled-content style="fixed-case">P</jats:styled-content>red intake at d1 and d5 (both <jats:italic>P</jats:italic> &lt; 0·05), which may mediate such <jats:styled-content style="fixed-case">AVP</jats:styled-content>‐independent mechanisms. Urinary <jats:styled-content style="fixed-case">PGE</jats:styled-content>2 secretion was not influenced by <jats:styled-content style="fixed-case">P</jats:styled-content>red pretreatment, making a <jats:styled-content style="fixed-case">PGE</jats:styled-content>2‐mediated effect on renal <jats:styled-content style="fixed-case">AQP</jats:styled-content>2 translocation and water permeability unlikely. Increased efficacy of exogenous desmopressin at d1 and d5 indicates also a relative increase in <jats:styled-content style="fixed-case">AVP</jats:styled-content> sensitivity of the tubular cells after <jats:styled-content style="fixed-case">P</jats:styled-content>red intake.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The here presented data are compatible with an increased <jats:styled-content style="fixed-case">AVP</jats:styled-content> sensitivity and a partially <jats:styled-content style="fixed-case">AVP</jats:styled-content>‐independent regulation of <jats:styled-content style="fixed-case">AQP</jats:styled-content>2 translocation and renal fluid reabsorption during glucocorticoid treatment.</jats:p></jats:sec>