RESUMO
Maximum urine concentration capacity was studied in healthy adults using different routes and doses of administration of 1-deamino-8-d-arginine vasopressin (DDAVP)-desmopressin. Plasma levels of DDAVP showed a dose-dependent increase after the subcutaneous but not after the intranasal administration. The effect on urine osmolality was similar but more prolonged after the subcutaneous as compared to the intranasal route. We conclude that subcutaneous injection is a simple and reliable way of administering DDAVP. A dose of 4 micrograms in adults is optimum diagnostically and it corresponds to 20-40 micrograms administered intranasally.
Assuntos
Desamino Arginina Vasopressina , Capacidade de Concentração Renal/efeitos dos fármacos , Administração Intranasal , Adulto , Desamino Arginina Vasopressina/administração & dosagem , Desamino Arginina Vasopressina/sangue , Relação Dose-Resposta a Droga , Avaliação de Medicamentos , Feminino , Humanos , Injeções Subcutâneas , Masculino , Concentração Osmolar , Fatores de Tempo , Urina/análiseRESUMO
In patients given long-term treatment with lithium maximum urine osmolality was measured after 26 h of dehydration and after intranasal administration of desamino-8-D-arginine vasopressin (DDAVP). A high correlation was found between the results of the two tests suggesting that the DDAVP test is a suitable method of assessing renal concentrating ability in lithium-treated patients.
Assuntos
Arginina Vasopressina , Diurese/efeitos dos fármacos , Capacidade de Concentração Renal/efeitos dos fármacos , Lítio/efeitos adversos , Administração Intranasal , Adulto , Feminino , Humanos , Lítio/administração & dosagem , Lítio/uso terapêutico , Masculino , Pessoa de Meia-Idade , Concentração Osmolar , Sede , Fatores de Tempo , UrinaRESUMO
Maximum urine osmolality was measured during a 24-hour control period in normal ambulant and working subjects and hospital inpatients and compared with that achieved after intramuscular injection of 4 microgram desamino-cys-1-8-D-arginine vasopressin (DDAVP). Most of the normal subjects passed maximally concentrated urine at some time during the control period. The results suggest that in less active subjects or hospital inpatients the DDAVP test is a suitable method of assessing renal concentrating ability.
Assuntos
Arginina Vasopressina , Desamino Arginina Vasopressina , Capacidade de Concentração Renal , Adulto , Feminino , Humanos , Capacidade de Concentração Renal/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Concentração Osmolar , Valores de ReferênciaRESUMO
1. Healthy subjects, given a long-acting preparation of vasopressin intramuscularly, excreted a significantly less concentrated urine than when subjected to fluid deprivation for 28 h. 2. When fludrocortisone, a potent mineralocorticoid, was given in addition to vasopressin the urine was not significantly less concentrated than after fluid deprivation. 3. Oral urea-loading also enhanced the urine-concentrating power of vasopressin but its effect was less marked than that of fludrocortisone. Oral urea did not increase further the urine concentration achieved by combined fludrocortisone and vasopressin. 4. Renal concentrating power was assessed in fourteen patients with renal disease and impaired concentrating ability. Fludrocortisone significantly enhanced the urine concentration achieved by vasopressin alone and the resultant urine was not significantly less concentrated than that achieved by fluid deprivation. 5. The action of fludrocortisone in enhancing the urine-concentrating effect of vasopressin is similar to that of aldosterone and is probably due to the increased sequestration of solute in the renal medulla, caused by increased reabsorption of sodium chloride in the ascending limb of the loop of Henle. 6. In the clinical assessment of renal concentrating power, the combined use of fludrocortisone and vasopressin has potential advantages over established methods.