Urinary excretion of aquaporin-2 water channel in diabetic ketoacidosis.
We studied the changes in plasma arginine vasopressin (AVP) and urinary excretion of aquaporin-2 (UAQP-2) water channel in 3 patients with diabetic ketoacidosis. They had marked hyperglycemia of 27.9 +/- 2.8 mmol/l (mean +/- SEM), and elevated hemoglobin A1c of 8.8 +/- 1.4%. Circulatory blood volume was decreased by approximately 25%, which was determined by the changes in hematocrit. Plasma AVP levels were elevated to 10.3 +/- 3.0 pmol/l and UAQP-2, 578 +/- 200 fmol/mg creatinine (normal, 153 +/- 28) at the hospitalization. When hyperglycemia was improved by the intravenous infusion of a small dose of insulin plus fluid administration, both plasma AVP and UAQP-2 promptly decreased to 1.2 +/- 0.2 pmol/l and 252 +/- 29 fmol/mg creatinine on day 7, respectively. These alterations were concomitant with the recovery of circulatory blood volume. In the present study, UAQP-2, in addition to plasma AVP, indicates circulatory blood volume depletion, and the changes in UAQP-2 estimates the AVP-dependent recovery of circulatory blood volume during the therapeutic period in the patients with diabetic ketoacidosis.
Kusaka
Ikuyo
I
Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical School, Tochigi, Japan.
Saito
Takako
T
Nakamura
Tomoatsu
T
Nagasaka
Shoichiro
S
Ishibashi
Shun
S
Ishikawa
San-e
SE
D000328:Adult; D000368:Aged; D051399:Aquaporin 2; D051403:Aquaporin 6; D020346:Aquaporins / Q000652:urine*; D001127:Arginine Vasopressin / Q000097:blood; D015415:Biomarkers; D001786:Blood Glucose / Q000378:metabolism; D001810:Blood Volume / Q000502:physiology; D016883:Diabetic Ketoacidosis / Q000652:urine*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
C496023:AQP2 protein, human; D051399:Aquaporin 2; D051403:Aquaporin 6; D020346:Aquaporins; D015415:Biomarkers; D001786:Blood Glucose; D001127:Arginine Vasopressin