DDAVP Test For Renal Concentration Capacity: <i>Age-related Reference Intervals</i>

Tryding, Nils; Berg, Bertel; Ekman, Stephan; Nilsson, Jan-E; Sterner, Gunnar; Harris, Alice C.

doi:10.1080/00365599.1988.11690400

Cited by 32 publications

(22 citation statements)

References 9 publications

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“…This allowed us to conclude whether differences between ADPKD patients and healthy controls were due to the disease process itself, and not due to differences in age, sex distribution, or kidney function. These latter factors have been shown to influence maximal urine concentrating capacity (24,(36)(37)(38)(39). Second, we measured maximal endogenous urine concentrating capacity, as well as the reaction to DDAVP administration.…”

Section: Discussionmentioning

confidence: 99%

Vasopressin, Copeptin, and Renal Concentrating Capacity in Patients with Autosomal Dominant Polycystic Kidney Disease without Renal Impairment

Zittema¹,

Boertien²,

Beek

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Autosomal dominant polycystic kidney disease (ADPKD) is the most prevalent hereditary renal disease, characterized by cyst formation in the kidneys leading to end stage kidney failure. It is clinically acknowledged that ADPKD patients have impaired urine concentrating capacity, but the mechanism behind this observation is unknown.Design, setting, participants, & measurements Fifteen ADPKD patients (estimated GFR $60 ml/min per 1.73 m 2 ) and 15 age-and sex-matched healthy controls underwent a standard prolonged water deprivation test in which urine and plasma osmolality, vasopressin, and copeptin were measured. The effect of a synthetic vasopressin analog (desmopressin) injected at the moment of maximal urine concentrating capacity was also studied.Results After 14 hours of water deprivation, ADPKD patients tended to have higher plasma osmolality (P=0.07) and significantly higher vasopressin and copeptin levels (both P,0.05), whereas urine osmolality was similar in ADPKD patients and controls (710 versus 742 mOsmol/kg; P=0.61). Maximal urine concentrating capacity was lower in ADPKD patients (758 versus 915 mOsmol/kg in controls; P,0.001). At maximal urine concentrating capacity, plasma osmolality, vasopressin, and copeptin levels were significantly higher in ADPKD patients. The median increase in urine osmolality after desmopressin administration in ADPKD patients was less than in healthy controls.Conclusions Already early in their disease, ADPKD patients have impaired maximal urine concentrating capacity brought out upon dehydration, with no evidence of impaired hypothalamic response. To maintain fluid balance, vasopressin concentration increases, which is hypothesized to play a role in ADPKD disease progression.

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Section: Discussionmentioning

confidence: 99%

Vasopressin, Copeptin, and Renal Concentrating Capacity in Patients with Autosomal Dominant Polycystic Kidney Disease without Renal Impairment

Zittema¹,

Boertien²,

Beek

et al. 2012

Clinical Journal of the American Society of Nephrology

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“…The urine osmolality, determined cryoscopically, was considered to be normal when the following age-related values were reached: 850 mOsm/kg for persons ≤20 years old, 800 mOsm/kg for those aged 21-40 years, 700 mOsm/kg for those aged 40-60 years, and 600 mOsm/kg for persons ≥60 years old. [10] Anemia was defined as hemoglobin below 130 g/L for males and post-menopausal women and below 120 g/L for pre-menopausal women, as proposed by the World Health Organization. [11] Kidney sonography was performed by one dedicated doctor using a Vivid 3-General Electric ultrasound machine with sector probe of 3.5 MHz.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of Criteria for the Diagnosis of Balkan Endemic Nephropathy

Djukanović

Marić²,

Marinković

et al. 2007

Renal Failure

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Background. The diagnosis of Balkan endemic nephropathy (BEN) is often made using Danilovic's criteria. The aim of this study was to determine the prevalence, sensitivity, specificity, and predictive value of Danilovic's criteria and several additional indices. Methods. The study included 19 BEN patients, 23 BEN-suspected patients, 34 patients with other kidney diseases, and 23 healthy controls. The sensitivity and specificity of Danilovic's criteria was calculated, and these criteria, in addition to age, sex, blood pressure, creatinine clearance, glucosuria, urine osmolality, alkaline phosphatase, alpha 1-microglobulin, fractional sodium excretion, tubular phosphate reabsorption, kidney length, and volume, were combined in a logistic regression. Results. All examined persons were from a BEN-affected village (criterion 1), and all BEN, BENsuspected patients, and 12/23 healthy controls were from BEN families (criterion 2). None of the remaining Danilovic's criteria was found in the healthy controls. The prevalence of proteinuria, low specific gravity, and anemia (criteria 3-5) differed insignificantly among the patient groups. Azotemia and shrunken kidney (criteria 6 and 7) were significantly more frequent in BEN than in other patients. Only proteinuria showed high sensitivity and specificity in differentiating BEN and BEN-suspected patients from healthy persons, but no criteria differentiated BEN or BEN-suspected from other kidney diseases. Proteinuria is a significant predictor of both BEN and BENsuspected vs. healthy persons, and alpha 1-microglobulinuria is a significant predictor of BEN vs. other kidney diseases. Conclusion. Danilovic's criteria enabled a diagnosis of BEN only in chronic renal failure and differential diagnosis between BEN and healthy persons but not between BEN and other kidney diseases. Out of the examined indices of proximal tubular disorders, only alpha 1-microglobulinuria significantly discriminated BEN from other kidney diseases.

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“…Older adults showed lower values of maximum and higher values of minimum Uosm than children or young adults. In six groups of adults the median decrease in maximum Uosm was 3.4 mosm/kg/y (Lindeman et al, 1966;Rowe et al, 1976;Nadvornikova et al, 1980;Tencer, 1988;Tryding et al, 1988;Tan et al, 1991).…”

Section: Maximum and Minimum Uosm And Agementioning

confidence: 99%

“…In adults urine solute excretion ranged from 1365 mosm/ 24-h in miners on a rest day in Australia (Cross et al, 1989) to about 400 mosm/24 h*1.73 m 2 in sweet potato eaters in Papua New Guinea (Oomen, 1967) and 362 mosm/24-h in results of renal concentrating test with (n) vasopressin after high fluid intake (Bendz, 1985); (K)12-18 h fluid restriction and/or vasopressin (children: Winberg, 1959;Edelmann et al, 1967;Monnens, 1971;Uttley et al, 1972;Abyholm and Monn, 1979;Stapleton and Miller, 1988;Marild et al, 1992; Miles et al, 1954;Isaacson, 1960;Toor et al, 1965;Macarnon et al, 1975;Rowe et al, 1976;Alwall, 1978;Monson and Richards 1978;Curtis and Donovan, 1979;Güllner et al, 1980;Askergren et al, 1981;Koppeschaar et al, 1985;Tencer, 1988;Tryding et al, 1988;Tan et al, 1991;Baumgarten et al, 2000; decrease in maximum Uosm at an age above 20 y: 3.4 mosm/kg/y); (&) more than 18 h fluid restriction and/or high protein intake (Miles et al, 1954;Polacek et al, 1965;Lindeman et al, 1966;Nadvornikova et al, 1980) mean values ( * ) and regression lines (-) of minimum urinary osmolality in renal diluting tests in children and adults during high oral water intake or intravenous hypotonic saline (Lindeman et al, 1966;Klahr et al, 1967;Rodriguez-Soriano et al, 1981;DiScala and Stein, 1982).…”

Section: Renal Solute Excretionmentioning

confidence: 99%

24-h hydration status: parameters, epidemiology and recommendations

2003

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Hydration of individuals and groups is characterised by comparing actual urine osmolality (Uosm) with maximum Uosm. Data of actual, maximum and minimum Uosm in infants, children and adults and its major influencing factors are reviewed. There are remarkable ontogenetic, individual and cultural differences in Uosm. In the foetus and the breast-fed infant Uosm is much lower than plasma osmolality, whereas in children and adults it is usually much higher. Individuals and groups may show long-term differences in Uosm. In industrialised countries, the gender difference of Uosm is common. There are large intercultural differences of mean 24-h Uosm ranging from 860 mosm/kg in Germany, 649 mosm/kg in USA to 392 mosm/kg in Poland. A new physiologically based concept called 'free-water reserve' quantifies differences in 24-h euhydration. In 189 boys of the DONALD Study aged 4.0-6.9 y, median urine volume was 497 ml/24-h and median Uosm 809 mosm/kg. Considering meanÀ2 s.d. of actual maximum 24-h Uosm of 830 mosm/kg as upper level of euhydration and physiological criterion of adequate hydration in these boys, median free-water reserve was 11 ml/24-h. Based on median total water intake of 1310 ml/ 24-h and the third percentile of free-water volume of À156 ml/24-h, adequate total water intake was 1466 ml/24-h or 1.01 ml/ kcal. Data of Uosm in 24-h urine samples and corresponding free-water reserve values of homogeneous groups of healthy subjects from all over the world might be useful parameters in epidemiology to investigate the health effects of different levels of 24-h euhydration.

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DDAVP Test For Renal Concentration Capacity: Age-related Reference Intervals

Cited by 32 publications

References 9 publications

Vasopressin, Copeptin, and Renal Concentrating Capacity in Patients with Autosomal Dominant Polycystic Kidney Disease without Renal Impairment

Vasopressin, Copeptin, and Renal Concentrating Capacity in Patients with Autosomal Dominant Polycystic Kidney Disease without Renal Impairment

Evaluation of Criteria for the Diagnosis of Balkan Endemic Nephropathy

24-h hydration status: parameters, epidemiology and recommendations

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