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

• Published in: Clinical journal of the American Society of Nephrology 2012-06, Vol.7 (6), p.906-913
• Main Authors: Zittema, Debbie, Boertien, Wendy E, van Beek, André P, Dullaart, Robin P F, Franssen, Casper F M, de Jong, Paul E, Meijer, Esther, Gansevoort, Ron T
• Format: Article
• Language: English
• Subjects: Adult; Biomarkers - blood; Case-Control Studies; Deamino Arginine Vasopressin - administration & dosage; Disease Progression; Female; Glycopeptides - blood; Humans; Kidney - drug effects; Kidney - physiopathology; Kidney Concentrating Ability - drug effects; Male; Middle Aged; Netherlands; Neurophysins - blood; Osmolar Concentration; Polycystic Kidney, Autosomal Dominant - blood; Polycystic Kidney, Autosomal Dominant - physiopathology; Polycystic Kidney, Autosomal Dominant - urine; Protein Precursors - blood; Regression Analysis; Time Factors; Vasopressins - blood; Water Deprivation; Water-Electrolyte Balance; Young Adult
• ISSN: 1555-9041; 1555-905X
• DOI: 10.2215/CJN.11311111

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. 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. 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