title: Effect of metoclopramide therapy on arginine vasopressin excretion and renal water handling in premature infants.
abstract: The role of endogenous dopamine (DA) in regulating arginine vasopressin (AVP) release and renal water excretion was studied in 10 premature infants with a mean birth weight of 1,341 g (range 1,150-1,660 g) and a mean gestational age of 30.2 weeks (28-33 weeks), who were given metoclopramide (MTC), a specific DA antagonist. It was demonstrated that in response to MTC urine flow rate increased significantly from a basal value of 0.90 +/- 0.07 to 1.27 +/- 0.09 ml/min/1.73 m2 (mean +/- SE; p less than 0.01), urinary sodium excretion from 6.10 +/- 1.47 to 11.7 +/- 2.24 microEq/min/1.73 m2 (p less than 0.025) and osmolar clearance from 0.38 +/- 0.044 to 0.600 +/- 0.075 ml/min/1.73 m2 (p less than 0.01). MTC administration did not cause any alterations in free water clearance, whereas urinary AVP excretion fell significantly from 49.38 +/- 10.13 to 32.66 +/- 6.53 ng/min/1.73 m2 (p less than 0.05) after MTC. It is concluded that, contrary to adults, in low birth weight premature infants endogenous DA is enhancing rather than inhibiting AVP release and the MTC-induced water diuresis is independent of the fall of AVP since free water clearance remained unaltered after MTC.
mesh_terms: D001127:Arginine Vasopressin / Q000652:urine*; D004231:Diuresis / Q000187:drug effects*; D004298:Dopamine / Q000502:physiology; D005767:Gastrointestinal Diseases / Q000188:drug therapy / Q000652:urine; D006801:Humans; D007010:Hyponatremia / Q000652:urine; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000188:drug therapy / Q000652:urine*; D007671:Kidney Concentrating Ability / Q000187:drug effects; D008297:Male; D008787:Metoclopramide / Q000627:therapeutic use*; D009318:Natriuresis / Q000187:drug effects
chemical_list: D001127:Arginine Vasopressin; D008787:Metoclopramide; D004298:Dopamine