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Abstract: FR-PO621

Possible Involvement of Upregulated Arginine Vasopressin in Fluid Retention on Peritoneal Dialysis

Session Information

Category: Fluid and Electrolytes

  • 901 Fluid and Electrolytes: Basic

Authors

  • Sanada, Kenya, University of Occupational and Environmental Health, Kitakyushu, Japan
  • Ueno, Hiromichi, University of Occupational and Environmental Health, Kitakyushu, Japan
  • Nakazono, Kazutoshi, University of Occupational and Environmental Health, Kitakyushu, Japan
  • Fujimoto, Yoko, University of Occupational and Environmental Health, Kitakyushu, Japan
  • Ueta, Yoichi, University of Occupational and Environmental Health, Kitakyushu, Japan
  • Otsuji, Yutaka, University of Occupational and Environmental Health, Kitakyushu, Japan
  • Miyamoto, Tetsu, University of Occupational and Environmental Health, Kitakyushu, Japan
Background

Fluid retention is a typical complication of peritoneal dialysis (PD), and interferes with the safety and long-term delivery of PD. Arginine vasopressin (AVP), which is synthesized in the hypothalamus, is involved in water reabsorption in the collecting ducts and could be involved in fluid retention. Here, we examined hypothalamic AVP synthesis during PD in both basic and clinical research.

Methods

1) First, after administration of 3% hypertonic saline (HTN) as dialysis solution for a short-term dwell or polyethylene glycol (PEG) as dialysis solution for a long-term dwell, we evaluated the fluorescence intensity of AVP-enhanced green fluorescent protein (eGFP) in the hypothalamus. The intensity of eGFP offers a quantitative indicator of AVP synthesis in transgenic rats. Second, we quantified Fos-like immnoreactive (IR) cells in several brain regions known to be involved in maintaining fluid homeostasis by control of AVP synthesis and/or having interactions with the hypothalamus.
2) We measured plasma AVP levels, plasma osmolality and urinary osmolality in 20 PD patients during visits.

Results

1) Fluorescence intensities for eGFP were significantly increased in the hypothalamus after administration of HTN and PEG. Immunohistochemistry for Fos revealed activation of several brain areas after administration of HTN and PEG.
2) Plasma AVP levels (5.5 ± 0.6 pg/mL) and plasma osmolality (303.4 ± 1.6 mOsm/kgH2O) increased significantly in PD patients, and these values were correlated (Rho = 0.56, P = 0.02, n= 20). In addition, a positive correlation was observed between plasma AVP levels and urine osmolality (Rho = 0.65, P = 0.03). Given these findings, we considered that the physiological function of AVP remained in PD patients.

Conclusion

To the best of our knowledge, this represents the first report to reveal an upregulation of hypothalamic AVP during PD by performing both basic and clinical research. Upregulation of hypothalamic AVP could induce fluid retention. These findings provide potential insights into fluid management for PD patients.