Lack of elevation of urinary albumin excretion among patients with chronic syndromes of inappropriate antidiuresis.
BACKGROUND
A recent study has revealed that acute and chronic administration of the vasopressin V2 receptor (V2R) agonist dDAVP induced a marked increase of urinary albumin excretion (UAE) in healthy rats and humans (Bardoux P et al. Nephrol Dial Transplant 2003; 18: 497-506). The occurrence of an elevation of UAE among patients with chronic syndromes of inappropriate antidiuresis has not been reported.


METHODS
We looked for the elevation of UAE in 24-h urine samples of the following patients: nine chronic SIADH patients, two patients with acute post-operative SIADH, three patients of the same family with nephrogenic syndrome of inappropriate antidiuresis (NSAID) and two patients with hyponatraemia due to surdosage of dDAVP in the setting of central diabetes insipidus.


RESULTS
There was no elevation of UAE in our patients (whether they presented with hyponatraemia or not), apart from a patient treated with supra-physiological doses of dDAVP. When she received 80 microg/day of dDAVP, her UAE was 42 mg/day. In this patient, UAE returned to the normal range (21 mg/day) when doses of dDAVP were tapered (20 microg/day).


CONCLUSIONS
The present study shows that chronic V2R stimulation generally does not result in a rise in UAE. The discrepancy between our results and those of the above-mentioned study could be explained by a dose-dependent effect of V2R stimulation on UAE.
Vandergheynst
Frédéric
F
General Internal Medicine Department, Erasme University Hospital, Brussels, Belgium. fvdgheyn@ulb.ac.be
Decaux
Guy
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000175:diagnosis* / Q000209:etiology; D050034:Antidiuretic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002908:Chronic Disease; D002940:Circadian Rhythm; D003894:Deamino Arginine Vasopressin / Q000009:adverse effects / Q000627:therapeutic use*; D003919:Diabetes Insipidus / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000188:drug therapy; D007177:Inappropriate ADH Syndrome / Q000139:chemically induced / Q000652:urine*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D017483:Receptors, Vasopressin / Q000819:agonists* / Q000235:genetics
D050034:Antidiuretic Agents; D017483:Receptors, Vasopressin; D003894:Deamino Arginine Vasopressin