Response of plasma vasopressin to changes in extracellular volume and/or plasma osmolality in patients on maintenance hemodialysis.

Abstract

The effect of changes in extracellular volume versus changes in plasma osmolality on arginine vasopressin (AVP) release was studied in 6 patients with terminal renal failure maintained on chronic hemodialysis. The day of the study, the patients were treated by sequential ultrafiltration lasting 1 hour followed by a 3-hour conventional hemodialysis session. The ultrafiltration resulted in the removal of 460 to 1,170 ml (mean = 860 ml) of volume. Body weight during the combined procedures fell by 1.6 +/- 0.4 kg (mean +/- s.e.m.) while mean arterial pressure decreased only slightly. Plasma osmolality was unaffected by sequential ultrafiltration, but decreased from 313 +/- 4 mosm/kg H2O to 291 +/- 4 mosm/kg H2O during hemodialysis. Initial plasma AVP concentration was high at 4.45 +/- 0.25 pg/ml and remained unchanged during the sequential ultrafiltration at 4.55 +/- 0.37 pg/ml, but it fell during the hemodialysis to 2.47 +/- 0.45 pg/ml. A hypotensive episode observed in one patient towards the end of hemodialysis resulted in a sharp increase in plasma AVP concentration from 5.5 to 18 pg/ml. During the combined procedures, plasma AVP and plasma osmolality showed a close and linear correlation (r = 0.63, n = 23, p less than 0.001). These findings suggest that in patients on maintenance hemodialysis, changes in plasma osmolality play a predominant role in determining AVP secretion whereas a marked decrease in volume without ensuing hypotension has no effect on AVP release.

• Authors: T Fasanella d'Amore, J P Wauters, B Waeber, J Nussberger, H R Brunner
• Journal: Clinical nephrology (Clin Nephrol) Vol. 23 Issue 6 Pg. 299-302 (Jun 1985) ISSN: 0301-0430 [Print] Germany
• PMID: 4028528 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Vasopressins

Topics

• Blood Pressure
• Blood Volume
• Extracellular Space
• Humans
• Kidney Failure, Chronic (blood, therapy)
• Osmolar Concentration
• Renal Dialysis
• Ultrafiltration
• Vasopressins (blood, metabolism)