[The effect of hypervolemia on electrolyte level and and level of volume regulating hormones in patients with autosomal dominant polycystic kidney disease].
Autosomal dominant polycystic kidney disease (ADPKD) is one of the most frequent autosomal dominant diseases. Apart from kidneys it also includes alimentary system, nervous system, cardiovascular system. ADPKD is associated with endocrinal disorders of the hormones regulating volume, arterial blood pressure and water and electrolyte balance such as: ARO, AVP, Aldo. 24 patients with ADPKD (12 with normal renal function-gr. III, 12 with advanced renal insufficiency-gr. IV) and 15 healthy subjects to compare with-gr. I and 16 patients with advanced renal insufficiency of other origin than ADPKD-gr. II were examined. In all groups the levels of Aldo, AVP and ARO in blood and Na+, K+ and creatinine concentrations in blood serum were examined Also an excretion of Na, K, creatinine with urine and clearances: CNa, CK, CKrea and filtration fractions: FENa and FEK were determined. Arterial blood pressure was measured in all groups. The above described parameters were studied in standard conditions in patients in supine position and fasting-survey I; directly after intravenous infusion of 1000 ml 0.16 M NaCl at 16.7 ml/min for 1 h-survey II and two hours after intravenous infusion-survey III. Isotonic intravenous infusion of natrium chloride increased central blood volume in the examined patients (induced hypervolemia). The received results were compared among groups in standard conditions (before infusion) as well as reaction of all groups to increased central volemia was compared. On the basis of the received results it was observed that the patients with ADPKD with normal renal function (gr III) show a significant increase of ARO, AVP, arterial blood pressure what differs them from healthy individuals (gr. I). The increased values of the above mentioned parameters were typical for the patients with chronic renal insufficiency regardless to a cause of the failure (gr. II). Consequently, patients with ADPKD showed some hormonal disorders typical for patients with advanced renal insufficiency despite fairly big difference in creatinine level and renal function condition among groups. Comparing the groups with advanced renal insufficiency (gr. II and gr. IV) it was shown that despite the same creatinine and electrolytes level in blood serum they exhibited different renine activity of serum and arterial blood pressure. These parameters were higher in the group with ADPKD. After volume expansion by 1000 ml 0.16 M NaCl infusion no significant differences between renal response to induced hypervolemia in patients with ADPKD and control groups were observed. The received results show that the patients with ADPKD exhibit disorders in hormonal regulation, water and electrolyte balance and in value of arterial blood pressure regardless to a degree of renal function. Thus genetic disease alone predisposes to the above mentioned disorder. Nevertheless, patients with ADPKD show normal mechanisms of renal volemic regulation in volume expansion conditions that can be compared to control groups. It also means that renal response to induced hypervolemia is similar in all the examined groups and is independent of renal function degree.
Michalski
A
A
Katedra i Klinika Chorób Wewnetrznych i Zawodowych Slaskiej Akademii Medycznej w Zabrzu.
Grzeszczak
W
W
D000328:Adult; D001834:Body Water / Q000378:metabolism*; D003404:Creatinine / Q000097:blood; D004573:Electrolytes / Q000378:metabolism*; D005215:Fasting / Q000502:physiology; D006801:Humans; D007262:Infusions, Intravenous; D007552:Isotonic Solutions / Q000008:administration & dosage; D016891:Polycystic Kidney, Autosomal Dominant / Q000503:physiopathology*; D012083:Renin / Q000097:blood*; D016683:Supine Position / Q000502:physiology; D014667:Vasopressins / Q000097:blood*
D004573:Electrolytes; D007552:Isotonic Solutions; D014667:Vasopressins; D003404:Creatinine; D012083:Renin
Wpływ hiperwolemii na gospodarke wodno-elektrolitowa oraz stezenia hormonów bioracych udział w regulacji objetościowej u chorych ze zwyrodnieniem wielotorbielowatym nerek.