Renal response to an oral protein load in patients with central diabetes insipidus before and after treatment with vasopressin

J Nephrol. 2019 Jun;32(3):411-415. doi: 10.1007/s40620-018-00575-x. Epub 2019 Feb 19.

Abstract

Aim: Different factors have been hypothesized to play a role in the cascade of events associated with the protein-induced glomerular response. However, scant data are available on the possible functional effect of vasopressin (VP) on the glomerular filtration rate (GFR) in humans with central diabetes insipidus (CDI), which was the aim of the present study.

Method: Renal function was studied under fasting conditions (baseline) and after a meat meal in 16 patients with CDI before and after treatment with desmopressin (DDAVP) and in 16 control subjects. GFR was measured by the inulin method.

Results: At baseline, the GFR was lower in patients with CDI. Treatment with DDAVP resulted in an insignificant increase in GFR, which was not statistically different from untreated patients. After an acute oral protein load, the GFR increased, peaking at 45 min post meal in controls, and at 135 min post meal in treated and untreated CDI patients.

Conclusion: After a meat meal, the peak GFR response is delayed in CDI patients suggesting that VP might indirectly affect tubule-glomerular feedback.

Keywords: Diabetes insipidus; Glomerular filtration rate; Inulin; Vasopressin.

MeSH terms

  • Administration, Oral
  • Adult
  • Antidiuretic Agents / therapeutic use
  • Deamino Arginine Vasopressin / therapeutic use*
  • Diabetes Insipidus / metabolism
  • Diabetes Insipidus / physiopathology
  • Diabetes Insipidus / therapy*
  • Dietary Proteins / administration & dosage*
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate / drug effects
  • Glomerular Filtration Rate / physiology*
  • Humans
  • Kidney / drug effects
  • Kidney / physiopathology*
  • Male
  • Retrospective Studies
  • Sodium / urine
  • Treatment Outcome

Substances

  • Antidiuretic Agents
  • Dietary Proteins
  • Sodium
  • Deamino Arginine Vasopressin