Antidiuretic action of prolactin in the rat with diabetes insipidus.

Rats with hereditary hypothalamic diabetes insipidus, devoid of endogenous ADH, exhibited a prompt antidiuresis when injected subcutaneously or intraarterially with ovine prolactin. The antidiuresis was accompanied by a decrease in free water clearance and an increase in urine osmolality without a change in osmolal clearance or creatinine excretion. Measurement of PAH and insulin clearances indicated that prolactin had no effect on renal plasma flow or glomerular filtration rate. Prolactin injection caused a transient decrease in urinary sodium excretion, but proximal tubular sodium reabsorption, estimated by lissamine green transit time, was unaffected. The antidiuretic effect of prolactin could not be attributed to ADH contamination of the ovine prolactin preparation. Kidney cyclic AMP content was increased significantly 5 min after injection of prolactin. Thus, prolactin has an antidiuretic effect similar to that which occurs as a result of ADH action on the kidney and does not require either the release or the presence of ADH in order to cause the antidiuresis. Further, the impaired water excretion cannot be attributed to an increase in proximal tubular sodium reabsorption or to alteration of renal hemodynamics. It is suggested that prolactin has a direct ADH-like action on the kidney resulting in antidiuresis.     

Halofenate versus clofibrate in the management of true diabetes insipidus

The antidiuretic effect of two chemically related drugs, clofibrate and halofenate, was tested in a patient with pitressin-sensitive diabetes insipidus. The conventional daily dosage of 2 g clofibrate failed to control the symptoms of this patient; in order to obtain an adequate response the dosage had to be increased to 4 g daily.Halofenate at a dosage of 2 g daily, an amount equivalent in hypolipidemic activity to 4 g per day of clofibrate, significantly reduced water intake and output, while urinary osmolarity was markedly increased.It is concluded that (1) the antidiuretic effect of clofibrate may be dose-related, and that (2) halofenate also possesses some antidiuretic activity.     

Role of substance P in water homeostasis.

The effect of the naturally occurring peptide substance P on release of antidiuretic hormone (ADH) was studied in anesthetized dogs. Intravenous infusions of substance P in doses of 0.5, 5.0, and 50 ng/kg/min increased plasma concentrations of ADH in a dose-related fashion. At the two low doses, this increase occured in the absence of changes in urine volume, sodium excretion, free water clearance, and urinary cyclic AMP excretion. In addition, when substance P was administered in a concentration of 0.5 ng/kg/min, plasma levels of ADH were increased even though blood pressure did not change, suggesting that substance P may release antidiuretic hormone by a direct mechanism. Intrarenal infusions at a rate of 0.5 and 5 ng/kg/min caused dose-related decreases in free water clearance and significant increases in urinary cyclic AMP excretion. These data suggest that substabce P may play an important role in the regulation of water balance.     

Familial ADH-responsive diabetes insipidus: response to thiazides and chlorpropamide

Twenty cases of familial ADH-responsive diabetes insipidus were identified within five generations, and eight patients were studied by one of two established dehydration protocols. In each case there was partial to total failure of response to the initial administration of ADH which was slowly corrected by continued administration. This initial failure can lead to misinterpretation of the dehydration test unless the medullary solute washout effect is taken into account in chronically polyuric patients.Treatment consisted of thiazides and/or chlorpropamide. All cases responded well.The response to chlorpropamide suggests that the failure of ADH production is not complete in these patients, and that the major defect is a failure of ADH release in response to normal stimuli. Chlorpropamide may act by either facilitating ADH release or by synergistically interacting with available ADH at the tubular level.     

Circulating antidiuretic hormone in the X-irradiated rat

Male rats exposed to 500 R of whole-body x-irradiation were allowed food and water ad libitum and housed in metabolism cages; water and food intake and urinary and fecal excretion were recorded daily. Urine output increased 200% during the first 24 hours after irradiation. No significant changes occurred in daily sodium, potassium, urea, or total solute excretion, although calcium excretion approximately doubled after irradiation. The marked increase in free water excretion implicates antidiuretic hormone (ADH) in this phenomenon. Application of a sensitive bioassay for ADH permitted measurement of plasma ADH concentrations in undisturbed, unanesthetized rats before and after irradiation. ADH levels were lower and frequently not detectable 24 hours after exposure. High ADH levels, however, could be provoked in irradiated rats by hemorrhage, indicating that the receptor cells and secretory ability of the posterior pituitary remained intact. Furthermore, irradiated rats responded normally to small intravenous injections (4 to 8 microU) of exogenous ADH. Rats with congenital diabetes insipidus given daily injections of Pitressin showed no postirradiation diuresis. Lastly, increased urinary calcium excretion may result from hypercalcemia which is known to induce diuresis through calcium-vasopressin antagonism. These results further suggest that the diuretic response is due to decreased circulating ADH.     

Influence of season on plasma antidiuretic hormone, angiotensin II, aldosterone and plasma renin activity in young volunteers

We investigated seasonal changes in hormonal and thermoregulatory responses. Eight volunteers were subjected to the experiment at four times of the year: around the vernal and autumnal equinoxes, and at the summer and winter solstices at latitude 35° N. Plasma antidiuretic hormone (ADH), angiotensin II (ANG II), aldosterone (ALD) and plasma renin activity (PRA) were analyzed before and after water immersion. Seasonal changes in thermoregulatory responses were assessed by measuring core temperature and sweat rate during immersion of the leg in hot water (at 42°C) for 30 min in a room maintained at 26°C. The concentration of plasma ADH and ALD before water immersion was significantly higher in summer than in other seasons. The concentrations of ANG II and PRA did not show seasonal variations. Changes in tympanic temperature during water immersion showed significant differences between seasons, and were higher in winter than in other seasons. The sweat rate was significantly higher in summer than in other seasons. In summary, ADH and ALD concentrations displayed a seasonal rhythm with marked elevation in summer; this may be a compensative mechanism to prevent dehydration from increased sweat loss during summer due to heat acclimatization.     

Role of antidiuretic hormone in hyponatremia in patients with isolated adrenocorticotropic hormone deficiency.

We found symptomatic hyponatremia in four elderly patients in which serum sodium (Na) levels ranged from 101 to 122 mEq/l. All 4 patients had low levels of plasma adrenocorticotropic hormone (ACTH), serum cortisol, and urinary excretion of 17-OHCS, and poor responses of ACTH to exogenous insulin and antidiuretic hormone (ADH). Other pituitary hormones were all normal. They were therefore diagnosed as having isolated ACTH deficiency. Plasma ADH was relatively high despite hypoosmolality which was associated with the hyponatremia. Water loading test revealed impaired water excretion and poor suppression of plasma ADH. Replacement with 20-30 mg hydrocortisone completely restored the serum Na level and restored the plasma ADH level to the normal range in all 4 patients. Other factors such as decreased glomerular filtration, enhanced urinary Na loss and decreased Na intake were also included. These results indicate that there is marked hyponatremia and that in the presence of hypoosmolality the sustained secretion of ADH is the key factor in causing the impaired water excretion and hyponatremia in isolated ACTH deficiency.     

Renal excretion capacity in hydrated desert rodents (Jaculus orientalis andJaculus deserti)

Summary The capacity to excrete a water load was studied in rats and in two desert rodents (Jaculus orientalis andJaculus deserti) adapted to either 5 or 30°C ambient temperature. The rat is able to eliminate the entire water load regardless of thermal adaptation. Cold-adaptedJ. orientalis andJ. deserti excreted 60% of the water load in comparison to 20–30% in warm-adapted jerboas.At both adaptation temperatures, antidiuretic hormone (ADH) concentration was estimated at maximum diuresis in the two desert species. Though hydration induced a significant decrease in ADH concentration in both species, its level in the plasma remained relatively high. The decrease was more pronounced inJ. orientalis thanJ. deserti.Abbreviation ADH antidiuretic hormone     

Evaluation by capacitance measurements of antidiuretic hormone induced membrane area changes in toad bladder

A technique for estimating effective transepithelial capacitance in vitro was used to investigate changes in epithelial cell membrane area in response to antidiuretic hormone (ADH) exposure in toad bladder. The results indicate that transepithelial capacitance increases by about 30% within 30 min after serosal ADH addition and decreases with ADH removal. This capacitance change is not blocked by amiloride and occurs whether or not there is a transepithelial osmotic gradient. It is blocked by methohexital, a drug which specifically inhibits the hydro-osmotic response of toad bladder to ADH. We conclude that the hydro-osmotic response of toad bladder to ADH is accompanied by addition of membrane to the plasmalemma of epithelial cells. This new membrane may contain channels that are permeable to water. Stimulation of Na⁺ transport by ADH is not related to membrane area changes, but appears to reflect activation of Na⁺ channels already present in the cell membrane before ADH challenge.     

Plasma antidiuretic hormone (ADH) concentrations in cattle, during various water and feed regimes

Twelve steers of three different breeds were exposed to five feed and water regimes in order to characterize changes in plasma antidiuretic hormone (ADH) concentrations. No breed differences were found in plasma ADH concentration. Plasma ADH concentration rose (4.2 to 22.0 pg/ml) during dehydration. By 3 hr hydration, plasma ADH concentrations dropped dramatically (over 50%) to 9.2 pg/ml. No changes in plasma ADH concentrations occurred during feed restriction and refeeding. Hematocrit percentages were also determined and differences are hypothesized to relate to probable differences in environmental adaptability and genetic selection for meat or milk production among the three breeds.     

Guía clínica de manejo de la diabetes insípida y del síndrome de secreción inapropiada de hormona antidiurética en el postoperatorio de la cirugía hipofisaria

Changes in water metabolism and regulation of vasopressin (AVP) or antidiuretic hormone (ADH) are common complications of pituitary surgery. The scarcity of studies comparing different treatment and monitoring strategies for these disorders and the lack of prior clinical guidelines makes it difficult to provide recommendations following a methodology based on grades of evidence. This study reviews the pathophysiology of diabetes insipidus and inappropriate ADH secretion after pituitary surgery, and is intended to serve as a guide for their diagnosis, differential diagnosis, treatment, and monitoring.     

Influence of Desmopressin on water-salt homeostasis and the orthostatic tolerance during head-down tilting

Influence of Desmopressin, a synthetic analog of antidiuretic hormone (ADH), on the water-salt metabolism and orthostatic tolerance in humans during head-down tilting (HDT 15°) for 24 h has been studied. Smaller decrease in the total body water and extracellular fluid content, suppression of diuresis, and positive water balance were observed after Desmopressin administration as compared to the control group (without ADH). At the same time, the tolerance of the standard orthostatic test is increased. Thus, Desmopressin has been shown to prevent hypohydration of the body under the HDT conditions and, hence, an increase of orthostatic tolerance.     

Antidiuretic hormone infusion reduces taurine and NaCl-induced hypernatremia in the rats

Summary Rats drinking taurine and hypertonic saline (T + S) develop severe hypernatremia, but rats drinking either T or S alone do not. One hypothesis for this disruption of homeostasis is that the T + S combination interferes with the actions of antidiuretic hormone (ADH). Rats drinking T + S developed severe hypernatremia (170 mmol/L) by day 8 when infused with distilled water by osmotic minipumps, but maintained plasma sodium below 150 mmol/ L when infused with ADH. Cumulative water balance in T + S drinkers receiving ADH was consistently higher than in those not receiving ADH. However the ratio of cumulative sodium balance to cumulative water balance suggests little uniform advantage to rats receiving ADH nor does comparison of urine osmolality in the two groups. Precisely how ADH administration reduces hypernatremia in T + S drinking rats remains unclear, but the hypothesis that T + S interferes with the action of ADH in its regulation of extracellular fluid volume and osmolality remains viable.Supported by FMHS Project Grant CP/96/22 and St. George's University.     

Alteration in surface substructure of frog urinary bladder by calcium ionophore, verapamil and antidiuretic hormone

The calcium antagonist verapamil and the calcium ionophore A23187 have been shown to inhibit the hydro-osmotic actions of antidiuretic hormone (ADH) presumably by different mechanisms. Presently, urinary bladders of the frog (Rana pipiens) were examined under SEM following exposure to calcium ionophore A23187, verapamil and ADH in the presence and absence of an osmotic gradient. Cells exposed to ADH show marked changes in surface substructure which is accompanied by an expansion of microridges, cell borders and the appearance of microvilli in the granular cells. The microvilli are pronounced and appear at the junction of microridges. In the presence of an osmotic gradient, ADH induces granular cell swelling and some cells show a blistering effect. Calcium ionophore, in the absence of an osmotic gradient, induced pronounced morphological changes in the granular cells, where the microvilli become prominently visible as 'finger-like' projections. This effect may be due to the action of calcium in promoting elongation of microtubules. Cells exposed to ionophore plus ADH are indistinguishable from ionophore alone. The most apparent effect of verapamil on surface substructure was on the elevation of the mitochondrial-rich cells above the surrounding granular cells. These cells show some degree of separation from the granular cells and are accentuated in tissues exposed to verapamil plus ADH. The present observations suggest that these agents, verapamil and calcium ionophore, have marked effects on cellular morphology. These actions are mediated through alterations in calcium movements and reflect the relative importance of cellular calcium in transepithelial water flow and the actions of antidiuretic hormone.     

Role of calmodulin in antidiuretic hormone mediated water transport

Several classes of tricyclic antidepressants inhibit the action of antidiuretic hormone (ADH) and cyclic adenine monophosphate (cAMP) on osmotic water flow across toad urinary bladder without any effect on sodium transport. This finding suggests that calmodulin is involved in the hydroosmotic action of ADH (and of serosal hypertonicity), possibly in inducing exocytosis at the luminal border of vesicles rich in water channels.     

Fluid conservation in athletes: responses to water intake, supine posture, and immersion

The roles of antidiuretic hormone (ADH) and aldosterone in the elicited diuretic responses of trained and untrained men to seated, supine, and head-out water immersed conditions were studied. Volunteers were comprised of groups of six untrained individuals, six trained swimmers, and six trained runners. Each subject underwent three protocols, six hours in a seated position, supine position, or immersion (35 degrees C water). The last two protocols were preceded and followed by 1 h of seated position. After 10 h of fasting, 0.5% body wt of water was drunk. One hour later the trained groups had higher urine osmolalities (P less than 0.05) and urinary excretion rates of ADH (P less than 0.05) and lower urine flow rates (P less than 0.05) than untrained subjects. Throughout the sitting protocol, urinary ADH was also higher in both trained groups (P less than 0.05). Both supine posture and immersion resulted in significant decreases in urinary ADH in the untrained subjects (P less than 0.05) but no changes wer noted in swimmers and only during the second hour of immersion in the runners (P less than 0.05). The natriuresis and kaliuresis were greater during immersion than in the supine position but plasma renin activity, measured only in trained groups, and plasma aldosterone, measured in the untrained group, were decreased similarly with both protocols. The increases in urinary sodium excretion and urine flow rate were lower in trained than untrained subjects during the supine and immersion protocols (P less than 0.05). The data are compatible with an increased osmotic but decreased volume sensitivity of ADH control in trained men.     

Evolutionary Advantages of Participation of Vasopressin instead of Vasotocin in Regulation of Water–Salt Balance in Mammals

In experiments on non-anesthetized Wistar white rats there was studied reaction of kidney to an intramuscular injection of arginine vasotocin or arginine vasopressin at doses from 0.001 to 0.05 µg/100 g body mass on the background of a water load. Water (5 ml/100 g body mass) was administered through a catheter into stomach to suppress secretion of endogenous antidiuretic hormone (ADH). In experiments with water administration, diuresis increased due to a decrease of osmotic permeability of renal tubules and to excretion of osmotically free water, with the constant clearance of sodium ions. Injection of 0.05 µg arginine vasopressin led to a marked decrease of diuresis due to a rise of reabsorption of osmotically free water without elevation of excretion of osmotically active substances. Injection of the same dose of arginine vasotocin resulted in no increase of diuresis; however, reabsorption of osmotically free water and excretion of osmotically active substances including sodium ions were more pronounced. Hence, both vasotocin and vasopressin increased osmotic permeability of the tubular epithelium, but vasotocin, unlike vasopressin, promoted reduction of reabsorption of sodium ions and their loss with urine. A suggestion is made that one of the reasons for replacement in mammals of the molecular ADH forms (vasotocin by vasopressin) was the absence of the pronounced natriuretic effect in arginine vasopressin. This was of crucial significance to preserve sodium ions in the organism, to maintain water–salt balance in animals adapted to the terrestrial life, and to provide not only osmo-, but also volumoregulation.     

The effect of glucocorticoids on the diluting capacity of the kidney of a desert rodent: Gerbillus campestris]

The ability to excrete a water load was studied in Wistar rats and in gerbils (Gerbillus campestris). The rat excreted the entire water load in less than 2 h whereas Gerbillus campestris excreted less than 60% of the water load in 4 h. The gerbils which had received a dose of 15 micrograms/100 g body weight dexamethasone improved their rate of excretion which attained 92 +/- 6% in 2 h 30 min. The antidiuretic hormone (ADH) measured by radioimmunoassay at the time of maximum diuresis was undetectable in rats; in contrast, in gerbils the level of ADH remained relatively high (55.4 +/- 6.7 pg/ml). We conclude that the partial inability of the gerbil's kidney to excrete a water load is due to a high ADH level and probably to a low concentration of glucocorticoids.     

Renal proton magnetic resonance in experimental acute renal failure in rats

Cortical, medullary and papillary T1 and T2 water proton relaxation times were measured at 37 degrees C, 20 MHz. The measurements were made using kidneys from rats affected by many forms of experimental acute renal failure (ARF), namely acute hemorrhagic hypovolemia, angiotensin II administration, antidiuretic hormone (ADH) administration, glycerol, and other nephrotoxins (gentamicin, cisplatinum, cyclosporine), renal artery occlusion for different periods of time, and ureteral ligation. From the T1 and PW (percent tissue water content) the bound water (FB) and HF (percent water bound/g solid) were calculated according to a fast proton diffusion model. In most experimental models studied, the experiments were repeated following paramagnetic enhancement with GdDTPA administration (70 mmol/kg BW). By profiling the deviations from normal, it was possible to differentiate the ischemic (shortened T1, prolonged T2), obstructive (very high T1 and T2 in both cortex and medulla) and nephrotoxic (prolonged T2) forms of ARF. Significant changes in free/bound water compartments occurred, though their biological significance is unknown. T1 and T2 ratios before and after paramagnetic enhancement correlated well with estimates of glomerular filtration rate. In the first minutes following acute hemorrhagic hypovolemia, the intrarenal water distribution remained unchanged. After GdDTPA significant water proton T1 and T2 changes characterized the immediate posthemorrhagic state similar to the effect of ADH.     

The Effect of Ca and Antidiuretic Hormone on Na Transport across Frog Skin : I. Examination of interrelationships between Ca and hormone

Ca added to the solution bathing the outside of isolated frog skin causes a decrease in net Na transport across the skin while antidiuretic hormone (ADH) causes an increase. Possible interrelations between the effects of these agents have been examined. The decrease in Na transport caused by Ca was the same before and after treatment of the skin with ADH and the increase in transport caused by ADH was unaffected by the presence of Ca. The relationship between Ca concentration and degree of inhibition of Na transport was not appreciably altered by ADH. These results indicate that Ca and ADH do not compete but act independently at two different sites and these sites appear to be located on the same barrier to Na movement in the skin. Further, Ca causes a decrease in Cl influx across the short-circuited skin but ADH has no effect on Cl movement, again suggesting that the actions of these agents are independent.