The vasopressin and copeptin response to infection, severe sepsis, and septic shock*

Jochberger, Stefan; Dörler, Jakob; Luckner, Günter; Mayr, Viktoria D.; Wenzel, Volker; Ulmer, Hanno; Morgenthaler, Nils G.; Hasibeder, Walter; Dünser, Martin W.

doi:10.1097/ccm.0b013e3181957532

Cited by 95 publications

(80 citation statements)

References 28 publications

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“…Pro-AVP levels were higher in non-survivors and exhibited the best prognostic value at day 1-2 and at day 3-4 of shock. Later, pro-AVP levels were not very different between survivors and nonsurvivors, which could reflect a secondary AVP deficiency in the latter, as suggested by other authors [2,11]. Pro-ADM levels were also higher in non-survivors, but the prognostic value of this marker increased with time, unlike for pro-AVP.…”

supporting

confidence: 52%

“…In this sense, a correlation was found between pro-ADM and creatinine levels in a previous study in septic patients [8]. Moreover, continuous veno-venous hemofiltration was also shown to influence the correlation between AVP and pro-AVP plasma levels [11]. Interestingly, the prognostic value of pro-AVP and pro-ADM was not affected by creatinine level in the study of Dr Guignant et al [10].…”

mentioning

confidence: 79%

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Increased levels of pro-AVP and pro-ADM in septic shock patients: what could it mean?

Roch

2009

Intensive Care Med

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supporting

confidence: 52%

mentioning

confidence: 79%

Increased levels of pro-AVP and pro-ADM in septic shock patients: what could it mean?

Roch

2009

Intensive Care Med

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“…It is well known that certain diseases such as heart failure, acute myocardial infarction, hemorrhage and sepsis result in marked elevation of copeptin [31][32][33][34], but, in the general population, the most likely cause of having elevated copeptin is a low water intake. Given the multiple reports on an independent relationship between high copeptin and risk of cardiometabolic diseases, the potential of using increased hydration as a preventive tool for these diseases has acquired increasing interest.…”

Section: Discussionmentioning

confidence: 99%

Effects of hydration on plasma copeptin, glycemia and gluco-regulatory hormones: a water intervention in humans

et al. 2017

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Purpose High plasma copeptin, a marker of vasopressin, predicts diabetes mellitus. We tested if copeptin could be suppressed by increased water intake in healthy individuals, and if a water-induced change in copeptin was accompanied by altered concentrations of glucose, insulin or glucagon. Methods Thirty-nine healthy individuals underwent, in random order, 1 week of high water intake (3 L/day on top of habitual intake) and 1 week of normal (habitual) fluid intake (control). Fasting plasma concentrations of copeptin, glucose, insulin and glucagon were compared between the ends of both periods. Furthermore, acute copeptin kinetics were mapped for 4 h after ingestion of 1 L of water. Results After acute intake of 1 L water, copeptin was significantly reduced within 30 min, and reached maximum reduction within 90 min with on average 39% reduction (95% confidence interval (95 CI) 34-45) (p < 0.001) and remained low the entire test period (4 h). One week of increased water intake led to a 15% reduction (95 CI 5-25) (p = 0.003) of copeptin compared to control week. The greatest reduction occurred among subjects with habitually high copeptin and concentrated urine ("water-responders"). Water-responders had significant water-induced reduction of glucagon, but glucose and insulin were unaffected. Conclusions Both acute and 1 week extra water intake potently reduced copeptin concentration. In those with the greatest decline (water-responders), who are typically low drinkers with high baseline copeptin, water induced a reduction in fasting glucagon. Long-term trials assessing the effect of water on glucometabolic traits should focus on low-water drinkers with high copeptin concentration.

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“…Measurement of copeptin has also been suggested in the early exclusion of acute myocardial infarction among patients with suspected acute coronary syndrome [5,6,10]. In addition, copeptin measurement provides prognostic information in several acute conditions such as myocardial infarction [11], heart failure [12][13][14][15][16], infection [17][18][19], stroke [20,21], traumatic…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Sensitive Copeptin Assay for Clinical Measurement

Terzic¹,

Johansson-Fällgren²,

Ragnarsson³

et al. 2012

TOCCHEMJ

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Abstract:Background: Copeptin, a marker of vasopressin production, has been introduced for earlier diagnosis of acute myocardial infarction and other clinical emergencies. We evaluated the analytical performance of a new generation copeptin assay in an inter-laboratory trial.Methods: Precision, linearity range, carry-over contamination, the limit of blank and an inter-laboratory comparison trial for the copeptin US KRYPTOR assay were performed on the B·R·A·H·M·S KRYPTOR compact PLUS.Results: The intra-assay imprecision (CVs) was 12.6-2.2% and total imprecision over five days was 12.3-4.3% between 3.1 and 18.2 pmol/L. The assay had excellent linearity between 7-222 pmol/L. The limit of blank was 2.5 pmol/L and the limit of detection was 3.2 pmol/L, but was dependent on the analyte-free material used. No significant difference between sample type, such as serum or different types of plasma or reagent lots, was noted. The copeptin results remained unchanged upon five repeated freeze-thaw cycles. A set of patient samples with a mean copeptin concentration of 2.1-61 pmol/L run at two separate sites showed close correlation (r 2 =0.99, slope=1.01, intercept=0.35), indicating comparable results across laboratories. Conclusion:The new ultrasensitive copeptin KRYPTOR assay shows excellent inter-lab precision, opening up the possibility for international guidelines to exclude acute myocardial infarction.

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The vasopressin and copeptin response to infection, severe sepsis, and septic shock*

Cited by 95 publications

References 28 publications

Increased levels of pro-AVP and pro-ADM in septic shock patients: what could it mean?

Increased levels of pro-AVP and pro-ADM in septic shock patients: what could it mean?

Effects of hydration on plasma copeptin, glycemia and gluco-regulatory hormones: a water intervention in humans

Evaluation of a Sensitive Copeptin Assay for Clinical Measurement

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