Plasma copeptin and chronic kidney disease risk in 3 European cohorts from the general population

Boustany, Ray El; Tasevska, Irina; Meijer, Esther; Kieneker, Lyanne M.; Enhörning, Sofia; Lefèvre, Guillaume; Mohammedi, Kamel; Marre, Michel; Fumeron, Frédéric; Balkau, Beverley; Bouby, Nadine; Bankir, Lise; Bakker, Stephan J. L.; Roussel, Ronan; Melander, Olle; Gansevoort, Ron T.; Velho, Gilberto

doi:10.1172/jci.insight.121479

Cited by 37 publications

(27 citation statements)

References 60 publications

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“…Elevated concentrations of copeptin are prognostic markers in many clinical conditions, such as septic shock, pneumonia, cardiovascular disease, and diabetes (21)(22)(23). Furthermore, copeptin is elevated in CKD and proteinuria (24,25). Although this association could be attributed to decreased filtration by the kidneys, it has been shown that kidney clearance is not a main determinant of copeptin concentrations, because levels were unchanged in living kidney donors despite reduction in eGFR (26).…”

Section: Discussionmentioning

confidence: 99%

The Role of Volume Regulation and Thermoregulation in AKI during Marathon Running

Mansour¹,

Martin²,

Obeid³

et al. 2019

CJASN

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Background and objectivesMarathon runners develop transient AKI with urine sediments and injury biomarkers suggesting nephron damage.Design, setting, participants, & measurementsTo investigate the etiology, we examined volume and thermoregulatory responses as possible mechanisms in runners’ AKI using a prospective cohort of runners in the 2017 Hartford Marathon. Vitals, blood, and urine samples were collected in 23 runners 1 day premarathon and immediately and 1 day postmarathon. We measured copeptin at each time point. Continuous core body temperature, sweat sodium, and volume were assessed during the race. The primary outcome of interest was AKI, defined by AKIN criteria.ResultsRunners ranged from 22 to 63 years old; 43% were men. Runners lost a median (range) of 2.34 (0.50–7.21) g of sodium and 2.47 (0.36–6.81) L of volume via sweat. After accounting for intake, they had a net negative sodium and volume balance at the end of the race. The majority of runners had increases in core body temperature to 38.4 (35.8–41)°C during the race from their baseline. Fifty-five percent of runners developed AKI, yet 74% had positive urine microscopy for acute tubular injury. Runners with more running experience and increased participation in prior marathons developed a rise in creatinine as compared with those with lesser experience. Sweat sodium losses were higher in runners with AKI versus non-AKI (median, 3.41 [interquartile range (IQR), 1.7–4.8] versus median, 1.4 [IQR, 0.97–2.8] g; P=0.06, respectively). Sweat volume losses were higher in runners with AKI versus non-AKI (median, 3.89 [IQR, 1.49–5.09] versus median, 1.66 [IQR, 0.72–2.84] L; P=0.03, respectively). Copeptin was significantly higher in runners with AKI versus those without (median, 79.9 [IQR, 25.2–104.4] versus median, 11.3 [IQR, 6.6–43.7]; P=0.02, respectively). Estimated temperature was not significantly different.ConclusionsAll runners experienced a substantial rise in copeptin and body temperature along with salt and water loss due to sweating. Sodium and volume loss via sweat as well as plasma copeptin concentrations were associated with AKI in runners.PodcastThis article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2019_08_13_CJASNPodcast_19_09_.mp3

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Section: Discussionmentioning

confidence: 99%

The Role of Volume Regulation and Thermoregulation in AKI during Marathon Running

Mansour¹,

Martin²,

Obeid³

et al. 2019

CJASN

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“…The previous studies show that the higher the copeptin concentration, the higher the risk of decline of renal function and progression of CKD [16, 17]. Thus, Zittema et al in their study in IgA nephropathy patients found that a higher level of copeptin was associated with the severity and progression of the disease [18].…”

Section: Discussionmentioning

confidence: 99%

Dialysate copeptin and peritoneal transport in incident peritoneal dialysis patients

et al. 2019

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Purpose Systemic and intraperitoneal inflammation are characteristic features of patients with end-stage renal disease undergoing chronic peritoneal dialysis (PD). Arginine vasopressin (AVP) and its surrogate marker copeptin play important roles in many pathophysiological processes in chronic kidney disease. The aim of this study was to assess if copeptin concentrations in plasma and dialysate were related to peritoneal transport parameters and residual renal function (RRF) in incident PD patients. Methods In 37 clinically stable incident PD patients (mean age 50 years, 68% women, 32% diabetes), a 4 h peritoneal equilibration test (PET) was performed 4–6 weeks after the onset of PD. Plasma (at 2 h of PET) and dialysate (at 4 h) concentrations of copeptin, high-sensitivity C-reactive protein and interleukin-6 (IL-6) were determined. Results Plasma (80.7 ± 37.3 pg/mL) and dialysate (33.2 ± 18.0 pg/mL) concentrations of copeptin were correlated ( R s = 0.52, p = 0.001). Plasma and dialysate copeptin concentrations were negatively correlated with renal function as assessed by renal Kt/V ( R s = − 0.38; p = 0.021 and R s = − 0.33; p = 0.047, respectively). At PET, dialysate copeptin negatively correlated with D/P creatinine ( R s = − 0.35, p = 0.033), and positively with D/D0 glucose ( R s = 0.33, p = 0.045) and ultrafiltration ( R s = 0.37, p = 0.024). Multivariate analysis showed that low dialysate copeptin ( β = –0.30, p = 0.049) and high dialysate IL-6 ( β = + 0.40, p = 0.012) were independent determinants of higher D/P creatinine. Conclusions Dialysate copeptin was negatively associated with D/P creatinine in incident PD patients suggesting a potential influence of copeptin or AVP on peritoneal solute transport rate that might involve vasoactive mechanisms.

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“…The possible role of chronic vasopressin secretion in the incidence and progression of diabetic and non-diabetic CKD has been recently highlighted in various clinical [8,9,10,11,12] and experimental studies [7,13]. Chronic stimulation and/or overexpression of vasopressin receptors V1a and V2 have been associated with renal and cardiac alterations, while chronic blockade of both receptors has provided beneficial effects [14,15,16].…”

Section: Introductionmentioning

confidence: 99%

A Role for Both V1a and V2 Receptors in Renal Heat Stress Injury Amplified by Rehydration with Fructose

García-Arroyo

Muñoz-Jiménez

Gonzaga

et al. 2019

IJMS

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Chronic vasopressin secretion induced by recurrent mild heat stress exposure is significantly enhanced by limited rehydration with a fructose-containing beverage both in rodents and in humans. Moreover, this effect has been associated with upregulation of the polyol–fructokinase pathway and increased renal oxidative stress. Previously, we have shown that pharmacological inhibition of both V1a and V2 vasopressin receptors with conivaptan improved such renal alterations. The aim of this study was to evaluate the independent contributions of V1a and V2 receptors to the renal damage caused by mild heat stress and limited rehydration with a fructose-containing beverage. Osmotic minipumps were used to deliver either relcovaptan (0.64 mg/day) or tolvaptan (0.25 mg/day) in male Wistar rats for two weeks. Corresponding dilution vehicles were used as controls. To induce dehydration, rats were exposed to mild heat stress (37 °C for 1 h, Monday to Friday). All groups received a 10% fructose solution as a rehydration fluid for 2 h after mild heat stress. For the remainder of the day and on weekends, rats received tap water. The independent blockade of either the V1a or the V2 receptor prevented renal damage, reduced oxidative stress, and decreased plasma cortisol and systemic inflammation. However, the beneficial effects were regulated by different mechanisms. Tolvaptan inhibited polyol–fructokinase pathway overactivation, while relcovaptan prevented upregulation of the renin–angiotensin system and SGK1 expression. These data suggest that both V1a and V2 receptors participate in renal damage caused by heat stress-induced dehydration when fructose-containing beverages are used as rehydration fluids.

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Plasma copeptin and chronic kidney disease risk in 3 European cohorts from the general population

Abstract: INSERM and Danone Research Centre for Specialized Nutrition.

Cited by 37 publications

References 60 publications

The Role of Volume Regulation and Thermoregulation in AKI during Marathon Running

The Role of Volume Regulation and Thermoregulation in AKI during Marathon Running

Dialysate copeptin and peritoneal transport in incident peritoneal dialysis patients

A Role for Both V1a and V2 Receptors in Renal Heat Stress Injury Amplified by Rehydration with Fructose

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