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. 1978 Oct;62(4):738–744. doi: 10.1172/JCI109184

Role of Plasma Vasopressin in Impaired Water Excretion of Glucocorticoid Deficiency

John Boykin 1,2, Antoine Detorrenté 1,2, Abby Erickson 1,2, Gary Robertson 1,2, Robert W Schrier 1,2
PMCID: PMC371824  PMID: 701472

Abstract

In the present study, the effect of selective glucocorticoid deficiency on renal water excretion was investigated in conscious, trained, adrenalectomized dogs. The animals were studied before and after a water load while on replacement therapy of desoxycorticosterone acetate, 5 mg/day, and dexamethasone, 0.8 mg/day (group I), and while off dexamethasone for 5-9 days (group II). Before the water load the weight, inulin space, cardiac output, blood pressure, glomerular filtration rate, renal blood flow, plasma osmolality, and plasma antidiuretic hormone measured by radioimmunoassay were similar in both groups I and II. However, after a 40 ml/kg water load a marked impairment in renal water excretion in the glucocorticoid deficient dogs became apparent. Maximal free water clearance was −0.046±0.16 vs. 6.51±0.72 ml/min (P < 0.001) and minimal urinary osmolality was 425±56 vs. 82±3.5 mosmol/kg H2O (P < 0.001) in group II as compared to group I. Plasma antidiuretic hormone was maximally suppressed during the water load in group I to 0.34±0.08 pg/ml but remained elevated at 9.18±1.79 pg/ml (P < 0.005) in group II. This nonsuppressibility of plasma antidiuretic hormone during water loading in group II was associated with a significant tachycardia of 145±6 vs. 87±6 beats/min (P < 0.001) in group I and a significantly lower stroke volume of 27±0 vs. 59±0.5 ml/beat (P < 0.001). In conclusion, our results implicate a persistent secretion of antidiuretic hormone as an important factor in the impaired water excretion of glucocorticoid deficiency. A deleterious effect of glucocorticoid deficiency on cardiac function was observed and this hemodynamic alteration could be involved in initiating a nonosmolar, baroreceptor-mediated release of vasopressin.

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Selected References

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  1. Agus Z. S., Goldberg M. Role of antidiuretic hormone in the abnormal water diuresis of anterior hypopituitarism in man. J Clin Invest. 1971 Jul;50(7):1478–1489. doi: 10.1172/JCI106633. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Ahmed A. B., George B. C., Gonzalez-Auvert C., Dingman J. F. Increased plasma arginine vasopressin in clinical adrenocortical insufficeincy and its inhibition by glucosteroids. J Clin Invest. 1967 Jan;46(1):111–123. doi: 10.1172/JCI105504. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Anderson R. J., Cadnapaphornchai P., Harbottle J. A., McDonald K. M., Schrier R. W. Mechanism of effect of thoracic inferior vena cava constriction on renal water excretion. J Clin Invest. 1974 Dec;54(6):1473–1479. doi: 10.1172/JCI107895. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Anderson R. J., Pluss R. G., Berns A. S., Jackson J. T., Arnold P. E., Schrier R. W., McDonald K. E. Mechanism of effect of hypoxia on renal water excretion. J Clin Invest. 1978 Oct;62(4):769–777. doi: 10.1172/JCI109188. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Anderson R. J., Taher M. S., Cronin R. E., McDonald K. M., Schrier R. W. Effect of beta-adrenergic blockade and inhibitors of angiotensin II and prostaglandins on renal autoregulation. Am J Physiol. 1975 Sep;229(3):731–736. doi: 10.1152/ajplegacy.1975.229.3.731. [DOI] [PubMed] [Google Scholar]
  6. Berl T., Cadnapaphornchai P., Harbottle J. A., Schrier R. W. Mechanism of stimulation of vasopressin release during beta adrenergic stimulation with isoproterenol. J Clin Invest. 1974 Mar;53(3):857–867. doi: 10.1172/JCI107626. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Berl T., Cadnapaphornchai P., Harbottle J. A., Schrier R. W. Mechanism of suppression of vasopressin during alpha-adrenergic stimulation with norepinephrine. J Clin Invest. 1974 Jan;53(1):219–227. doi: 10.1172/JCI107541. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Boykin J., Cadnapaphornchai P., McDonald K. M., Schrier R. W. Mechanism of diuretic response associated with atrial tachycardia. Am J Physiol. 1975 Dec;229(6):1486–1491. doi: 10.1152/ajplegacy.1975.229.6.1486. [DOI] [PubMed] [Google Scholar]
  9. CUTLER R. E., KLEEMAN C. R., KOPLOWITZ J., MAXWELL M. H., DOWLING J. T. Mechanisms of impaired water excretion in adrenal and pituitary insufficiency. III. The effect of extracellular or plasma volume expansion, or both, on the impaired diuresis. J Clin Invest. 1962 Jul;41:1524–1530. doi: 10.1172/JCI104608. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Cadnapaphornchai P., Boykin J. L., Berl T., McDonald K. M., Schrier R. W. Mechanism of effect of nicotine on renal water excretion. Am J Physiol. 1974 Nov;227(5):1216–1220. doi: 10.1152/ajplegacy.1974.227.5.1216. [DOI] [PubMed] [Google Scholar]
  11. Clarke P. W., Cleghorn R. A., Ferguson J. K., Fowler J. L. FACTORS CONCERNED IN THE CIRCULATORY FAILURE OF ADRENAL INSUFFICIENCY. J Clin Invest. 1947 May;26(3):359–363. doi: 10.1172/JCI101817. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. DINGMAN J. F., DESPOINTES R. H. Adrenal steroid inhibition of vasopressin release from the neurohypophysis of normal subjects and patients with Addison's disease. J Clin Invest. 1960 Dec;39:1851–1863. doi: 10.1172/JCI104209. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. GARROD O., BURSTON R. A. The diuretic response to ingested water in Addison's disease and panhypopituitarism and the effect of cortisone thereon. Clin Sci. 1952 May;11(2):113–128. [PubMed] [Google Scholar]
  14. GARROD O., DAVIES S. A., CAHILL G., Jr The action of cortisone and desoxycorticosterone acetate on glomerular filtration rate and sodium and water exchange in the adrenalectomized dog. J Clin Invest. 1955 Jun;34(6):761–776. doi: 10.1172/JCI103131. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. GAUNT R., BIRNIE J. H., EVERSOLE W. J. Adrenal cortex and water metabolism. Physiol Rev. 1949 Oct;29(4):281–310. doi: 10.1152/physrev.1949.29.4.281. [DOI] [PubMed] [Google Scholar]
  16. GILL J. R., Jr, GANN D. S., BARTTER F. C. Restoration of water diuresis in addisonian patients by expansion of the volume of extracellular fluid. J Clin Invest. 1962 May;41:1078–1085. doi: 10.1172/JCI104558. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Green H. H., Harrington A. R., Valtin H. On the role of antidiuretic hormone in the inhibition of acute water diuresis in adrenal insufficiency and the effects of gluco- and mineralocorticoids in reversing the inhibition. J Clin Invest. 1970 Sep;49(9):1724–1736. doi: 10.1172/JCI106390. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. KLEEMAN C. R., CZACZKES J. W., CUTLER R. MECHANISMS OF IMPAIRED WATER EXCRETION IN ADRENAL AND PITUITARY INSUFFICIENCY. IV. ANTIDIURETIC HORMONE IN PRIMARY AND SECONDARY ADRENAL INSUFFICIENCY. J Clin Invest. 1964 Aug;43:1641–1648. doi: 10.1172/JCI105039. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. KLEEMAN C. R., KOPLOWITZ J., MAXWELL M. H., CUTLER R., DOWLING J. T. Mechanisms of impaired water excretion in adrenal and pituitary insufficiency. II. Interrelationships of adrenal cortical steroids and antidiuretic hormone in normal subjects and in diabetes insipidus. J Clin Invest. 1960 Sep;39:1472–1480. doi: 10.1172/JCI104166. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. KLEEMAN C. R., MAXWELL M. H., ROCKNEY R. E. Mechanisms of impaired water excretion in adrenal and pituitary insufficiency. I. The role of altered glomerular filtration rate and solute excretion. J Clin Invest. 1958 Dec;37(12):1799–1808. doi: 10.1172/JCI103773. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Kurokawa K., Aznar E., Descoeudres C., Zulueta A., Massry S. G. Effects of glucocorticoid deficiency on renal medullary cyclic adenosine monophosphate of rats. Clin Sci Mol Med. 1978 May;54(5):573–577. doi: 10.1042/cs0540573. [DOI] [PubMed] [Google Scholar]
  22. Lefer A. M. Influence of corticosteroids on mechanical performance of isolated rat papillary muscles. Am J Physiol. 1968 Mar;214(3):518–524. doi: 10.1152/ajplegacy.1968.214.3.518. [DOI] [PubMed] [Google Scholar]
  23. Lefer A. M., Verrier R. L., Carson W. W. Cardiac performance in experimental adrenal insufficiency in cats. Circ Res. 1968 Jun;22(6):817–827. doi: 10.1161/01.res.22.6.817. [DOI] [PubMed] [Google Scholar]
  24. Levi J., Grinblat J., Kleeman C. R. Water diuresis in the volume expanded glucocorticoid-deficient dog. Isr J Med Sci. 1973 Apr;9(4):429–437. [PubMed] [Google Scholar]
  25. Murphy B. E. Some studies of the protein-binding of steroids and their application to the routine micro and ultramicro measurement of various steroids in body fluids by competitive protein-binding radioassay. J Clin Endocrinol Metab. 1967 Jul;27(7):973–990. doi: 10.1210/jcem-27-7-973. [DOI] [PubMed] [Google Scholar]
  26. POULOS P. P. A constant-change (single injection) method for the estimation of the volume of distribution of substances in body fluid compartments. J Clin Invest. 1956 Aug;35(8):921–933. doi: 10.1172/JCI103345. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. REIDENBERG M. M., OHLER E. A., SEVY R. W., HARAKAL C. Hemodynamic changes in adrenalectomized dogs. Endocrinology. 1963 Jun;72:918–923. doi: 10.1210/endo-72-6-918. [DOI] [PubMed] [Google Scholar]
  28. ROEMMELT J. C., SARTORIUS O. W., PITTS R. F. Excretion and reabsorption of sodium and water in the adrenalectomized dog. Am J Physiol. 1949 Oct;159(1):124–136. doi: 10.1152/ajplegacy.1949.159.1.124. [DOI] [PubMed] [Google Scholar]
  29. Robertson G. L., Mahr E. A., Athar S., Sinha T. Development and clinical application of a new method for the radioimmunoassay of arginine vasopressin in human plasma. J Clin Invest. 1973 Sep;52(9):2340–2352. doi: 10.1172/JCI107423. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Schrier R. W., Berl T. Mechanism of the antidiuretic effect associated with interruption of parasympathetic pathways. J Clin Invest. 1972 Oct;51(10):2613–2620. doi: 10.1172/JCI107079. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Schrier R. W. Editorial: "Inappropriate" versus "appropriate" antidiuretic hormone secretion. West J Med. 1974 Jul;121(1):62–64. [PMC free article] [PubMed] [Google Scholar]
  32. Schrier R. W., Humphreys M. H. Factors involved in antinatriuretic effects of acute constriction of the thoracic and abdominal inferior vena cava. Circ Res. 1971 Nov;29(5):479–489. doi: 10.1161/01.res.29.5.479. [DOI] [PubMed] [Google Scholar]
  33. Share L., Travis R. H. Plasma vasopressin concentration in the adrenally insufficient dog. Endocrinology. 1970 Feb;86(2):196–201. doi: 10.1210/endo-86-2-196. [DOI] [PubMed] [Google Scholar]
  34. Stillman M. A., Recht L. D., Rosario S. L., Seif S. M., Robinson A. G., Zimmerman E. A. The effects of adrenalectomy and glucocorticoid replacement on vasopressin and vasopressin-neurophysin in the zona externa of the median eminence of the rat. Endocrinology. 1977 Jul;101(1):42–49. doi: 10.1210/endo-101-1-42. [DOI] [PubMed] [Google Scholar]
  35. Stolte H., Brecht J. P., Wiederholt M., Hierholzer K. Einfluss von Adrenalektomie und Glucocorticoiden auf die Wasserpermeabilität corticaler Nephronabschnitte der Rattenniere. Pflugers Arch Gesamte Physiol Menschen Tiere. 1968;299(2):99–127. [PubMed] [Google Scholar]
  36. Ufferman R. C., Schrier R. W. Importance of sodium intake and mineralocorticoid hormone in the impaired water excretion in adrenal insufficiency. J Clin Invest. 1972 Jul;51(7):1639–1646. doi: 10.1172/JCI106965. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. de Torrente A., Robertson G. L., McDonald K. M., Schrier R. W. Mechanism of diuretic response to increased left atrial pressure in the anesthetized dog. Kidney Int. 1975 Dec;8(6):355–361. doi: 10.1038/ki.1975.127. [DOI] [PubMed] [Google Scholar]

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