Hypovolemic stimuli and vasopressin secretion in man.

ABSTRACT

Different non-hypotensive hypovolemic stimuli were applied to 21 healthy and 20 uremic dialysis patients. The purpose was to study the effect on plasma arginine-vasopressin concentration, using orthostasis as a reference model. Orthostasis increased the plasma AVP level in healthy subjects as well as in uremic dialysis patients. In healthy subjects plasma AVP increased both when they were normohydrated and after they had been water-depleted. Lower body negative pressure (LBNP, -40 mmHg) was applied to 11 healthy males to induce a central blood volume decrease, equal to that induced by orthostasis. The plasma AVP increased in two subjects only who became hypotensive during the investigations. Ten hemodialysis patients were volume-depleted by isolated ultrafiltration. A flow directed Swan-Ganz catheter was used to measure the central intravascular pressures. Pulmonary capillary wedge pressure was reduced to normal or subnormal values during 1-2 h of ultrafiltration, without any significant changes in plasma AVP. Plasma AVP increased only in 2 patients, who became hypotensive during the investigations. Thus, of the present non-hypotensive volume stimuli only orthostasis was able to stimulate AVP secretion. Equal or even greater reductions in central blood volumes by other stimuli had no effect on AVP secretion. The results demonstrate that isolated stimulation of low-pressure volume receptors has no effect on the secretion of AVP in humans.