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FASCICOLI E ARTICOLI   I PIÙ LETTI   eTOC

ULTIMO FASCICOLOPANMINERVA MEDICA

Rivista di Medicina Interna

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,6

Periodicità: Trimestrale

ISSN 0031-0808

Online ISSN 1827-1898

 

Panminerva Medica 1998 Dicembre;40(4):294-8

 ORIGINAL ARTICLES

Plas­ma lev­els of argi­nine vas­o­pres­sin in hep­at­or­en­al syn­drome

Pasqualetti P., Casale R.*

From the Depart­ment of Inter­nal Med­i­cine and Pub­lic ­Health Facul­ty of Med­i­cine and Sur­gery, Uni­ver­sity of ­L’Aquila and the Divi­sion of 1st Inter­nal Med­i­cine, “S. Sal­va­tore” Gen­er­al Hos­pi­tal of Cop­pi­to, ASL 04, ­L’Aquila, Ita­ly

Back­ground. The eti­ol­o­gy of hep­at­or­en­al syn­drome is ­still incom­plete­ly under­stood, but the non-osmot­ic ­release of argi­nine vas­o­pres­sin (AVP) ­seems to ­have an impor­tant ­role in its path­o­gen­e­sis. The aim of the ­study was to inves­ti­gate the cir­cu­lat­ing plas­ma con­cen­tra­tions of AVP in ­patients ­with hep­a-t­or­en­al syn­drome, com­pared ­with ­healthy con­trols, in rela­tion ­with plas­ma osmo­lal­ity.
Meth­ods. ­Venous ­blood sam­ples ­were ­drawn in 20 ­healthy sub­jects and in 20 ­patients ­with HRS for the deter­mi­na­tion of the plas­ma lev­els of AVP by ­radio-immu­noas­say and of plas­ma osmo­lal­ity. The com­par­i­son ­between the two ­groups was car­ried out by the Stu­dent “t”-­test for ­unpaired ­data; the plas­ma AVP lev­els ­were cor­re­lat­ed ­with the val­ues of plas­ma osmo­lal­ity by lin­e­ar regres­sion anal­y­sis.
­Results. The ­patients pre­sent­ed sig­nif­i­cant­ly (p<0.001) high­er plas­ma AVP lev­els in ­respect to con­trols; on the con­trary, plas­ma osmo­lal­ity was sig­nif­i­cant­ly low­er in ­patients ­than in con­trols (p<0.005). Where­as a sig­nif­i­cant (r=0.83; p<0.001) rela­tion­ship was dem­on­strat­ed ­between plas­ma AVP and osmo­lal­ity in con­trols, no sig­nif­i­cant (r=0.23; p>0.05) cor­re­la­tion was ­found in ­patients.
Con­clu­sions. ­These ­results con­firm the exis­tence of an acti­va­tion in the ­release of AVP in hep­at­or­en­al syn­drome, due to the acti­va­tion of the sym­pa­thet­ic adren­al ­system and to hypo­na­trie­mia. The con­trac­tion of diu­re­sis in hep­at­or­en­al syn­drome, on the oth­er ­hand, is not due to a defi­cien­cy in plas­ma AVP. AVP ­release ­occurs ­despite low plas­ma osmo­lal­ity, ­which nor­mal­ly inhib­its its secre­tion. ­This ­great ­upset in func­tion­al organ­iza­tion, togeth­er ­with ­that of the atri­o­pep­tin-­renin-angio­ten­sin-aldos­te­rone ­system, ­could ­play an impor­tant ­role in pro­mot­ing and/or in the main­te­nance of the ­hydro-elec­tro­lyte imbal­ance ­that char­ac­teriz­es the syn­drome.

lingua: Inglese


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