Renal Response to Vasopressin in Premature Infants: What Is New?

Sulyok, E.

doi:10.1159/000242793

Cited by 13 publications

(9 citation statements)

References 34 publications

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“…Newborn animals may have a diminished end-organ responsiveness to AVP [27]. The specific binding sites for AVP in the rat medullopapillary membranes are hardly detectable after birth, but their number rapidly increases during the first 3 weeks of postnatal life.…”

Section: Discussionmentioning

confidence: 99%

“…Enhanced prostaglandin E (PGE) production by the neonatal kidney may also contribute to its impaired concentrating performance [29]. PGE interferes with the hydro-osmotic effect of AVP by inhibiting the AVP-induced increase of adenylate cyclase activity and c-AMP accumulation [27]. Absorption of water from the collecting ducts into the hypertonic medullary intersti-tium leads to urine concentration.…”

Section: Discussionmentioning

confidence: 99%

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A Comparison of Arginine Vasopressin Levels and Fluid Balance in the Perinatal Period in Infants Who Did and Did Not Develop Chronic Oxygen Dependency

et al. 2000

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Arginine vasopressin (AVP) levels on days 1, 3 and 5 and fluid balance in the perinatal period were assessed in 60 infants, median gestational age 27 weeks (range 24–33). Fluid input and output, urine osmolality and episodes of hyponatraemia were recorded on a daily basis. Forty-one infants subsequently developed chronic lung disease (CLD), they were more immature, of lower birthweight and had higher AVP levels on days 3 and 5 (p < 0.05) than the rest of the cohort. Despite similar levels of fluid input, compared to the non-CLD infants, those who developed CLD had higher urine osmolalities on days 1, 5, 6 and 7 (p < 0.05), but there were not significant differences between the two groups regarding urine output or episodes of hyponatraemia. Logistic regression analysis revealed AVP levels on day 3 were significantly correlated with the duration of oxygen dependency independent of other factors. We conclude elevated AVP levels in the perinatal period are associated with CLD development, but our results suggest they have little functional significance.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Comparison of Arginine Vasopressin Levels and Fluid Balance in the Perinatal Period in Infants Who Did and Did Not Develop Chronic Oxygen Dependency

et al. 2000

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“…In fact, it has been suggested that AVP may function primarily to maintain cardiovascular stability [15,22]. Moreover, it is not known how much hypervasopressinemia acts on the preterm's kidney, whose reduced concentrating capacity includes reduced glomerular filtration rate, relatively shortened loop of Henle in the midcortical and juxtamedullary glomeruli, and low serum urea concentrations due to low nitrogen intake [24,30]. The kidneys are not the only reason for incomplete urine concentration during the neonatal period.…”

Section: Discussionmentioning

confidence: 99%

“…Possible explanations include AVP as a response to hypovolemia in the patient with low blood pressure due either to premature birth or to hypoxia. Moreover, AVP hypersecretion may not affect renal tubular response and water balance significantly due to both structural and functional unresponsiveness of the distal tubule and collecting system in the premature kidney [1,15,24,29,30].…”

Section: Introductionmentioning

confidence: 99%

Vasopressin, atrial natriuretic factor and renal water homeostasis in premature newborn infants with respiratory distress syndrome

Ronconi¹,

Fortunato²,

Soffiati³

et al. 1995

Jpme

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Arginine vasopressin (AVP), human atrial natriuretic peptide (hANP), and body fluid and electrolyte balance were examined during the first five days of life in eleven premature infants (birthweight 1610 +/- 240 g, gestation 30 +/- 1 weeks) receiving mechanical ventilation for respiratory distress syndrome (RDS). Plasma hANP and urine AVP concentrations were determined by radioimmunoassay on the first, third and fifth days. Arginine vasopressin urine levels remained constantly elevated during the study period (mean +/- SD 13.5 +/- 7.8 day 1, 12.0 +/- 9.9 day 3, 13.2 +/- 5.1 ng/l day 5, p = n.s.), while plasma hANP was significantly increased on the third day (626 +/- 495 vs. 298 +/- 240 pg/ml on day 1, p < .05). Urine sodium concentration, urine osmolality and osmolality and osmolar clearance were elevated significantly as well on day 3, p < .05, and correlated to hANP levels. Body weight decreased during the study by 8.2% on the third day and by 11.3% of birthweight on the fifth day. A significant increase in creatinine clearance occurred after the third day (p < .01), while free water clearance remained essentially the same during the first five days of life. We speculate that an increase in plasma hANP concentration on day 3 of life results in a natriuresis and osmolar diuresis without correlations or temporal relationships to hypervasopressinemia of the premature neonate with RDS.

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“…Recently, Sulyok (23) demonstrated that the neonatal pituitary is capable of responding with arginine vasopressin release to physiologic stimulation and pathologic events commonly seen in the perinatal period.…”

Section: Referencesmentioning

confidence: 99%

Changes in Vasopressin, Atrial Natriuretic Factor, and Water Homeostasis in the Early Stage of Bronchopulmonary Dysplasia

et al. 1990

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ABSTRACT. Arginine vasopressin (AVP), atrial natriuretic factor, and water balance were examined in the infants with or without bronchopulmonary dysplasia (BPD) during the first 4 wk of life. Fourteen premature infants, nine in the early stage of BPD secondary to respiratory distress syndrome (BPD infants) and five healthy low birthwt infants (LBW infants), were the subjects of this study. The water and sodium balance, renal function, and plasma AVP and atrial natriuretic factor concentrations were determined during the first 4 wk of life. Plasma AVP and atrial natriuretic factor levels of BPD infants at the 4th wk of life were higher than those of LBW infants at the corresponding age. Urine osmolality was higher and free water clearance was lower in BPD infants at the 4th wk of life when compared with each parameter in LBW infants, respectively. Pac02 of BPD infants at the 4th wk of life was more elevated than that of LBW infants. These results suggest that elevated plasma AVP level may be related with pulmonary abnormalities and that atrial natriuretic factor may hence compensate the water retention resulted from the functionally activated AVP in the early stage of BPD. (Pediatr Res 27: [260][261][262][263]1990) Abbreviations ANF, atrial natriuretic factor AVP, arginine vasopressin BPD, bronchopulmonary dysplasia Ccr, creatinine clearance CH20, free water clearance FENa, fractional excretion of sodium LBW, low birthwt RDS, respiratory distress syndrome SIADH, syndrome of inappropriate secretion of antidiuretic hormoneInfants with chronic BPD sometimes develop edema, oliguria, and hyponatremia (1-3). Some of these symptoms are similar to those seen in patients with SIADH (4, 5). Recently, Hazinski et al. (2) found that some infants with chronic BPD have elevated plasma AVP levels and they speculated the functional significance of these elevated values. However, all these articles are about water balance in the chronic stage of BPD. It has not been well established whether the changes of plasma AVP levels and water balance in the early stage of BPD are the same with those in chronic BPD.On the other hand, ANF, found and isolated from the heart, has potent natriuretic and diuretic activities ( 6 4 , even in the premature infants (9). Among a variety of physiological effects of ANF such as natriuresis, vasodilation, inhibition of aldosterone release (6, lo), it is suggested that ANF suppresses the AVP release (1 1, 12). We therefore investigated whether there are differences in plasma values of AVP, ANF, and water homeostasis during the 1st mo of life between infants in the early stage of BPD and healthy LBW infants. MATERIALS AND METHODSStudy protocol. Fourteen premature infants (eight boys and six girls), nine in the early stage of BPD secondary to RDS (BPD infants) and five LBW infants, were the subjects of this study. Informed consent was obtained from each patient's parents. Our definition of BPD was based on three criteria: requirement of positive pressure ventilation as treatment for RDS in the 1st wk of...

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Renal Response to Vasopressin in Premature Infants: What Is New?

Cited by 13 publications

References 34 publications

A Comparison of Arginine Vasopressin Levels and Fluid Balance in the Perinatal Period in Infants Who Did and Did Not Develop Chronic Oxygen Dependency

A Comparison of Arginine Vasopressin Levels and Fluid Balance in the Perinatal Period in Infants Who Did and Did Not Develop Chronic Oxygen Dependency

Vasopressin, atrial natriuretic factor and renal water homeostasis in premature newborn infants with respiratory distress syndrome

Changes in Vasopressin, Atrial Natriuretic Factor, and Water Homeostasis in the Early Stage of Bronchopulmonary Dysplasia

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