Horm Metab Res 2003; 35(1): 62-66
DOI: 10.1055/s-2003-38393
Original Clinical
© Georg Thieme Verlag Stuttgart · New York

Urinary Excretion of Aquaporin-2 and Inappropriate Secretion of Vasopressin in Hyponatremic Patients after Cerebral Infarction

J.  Takagi 1 , K.  Otake 2 , N.  Nakao 2 , M.  Takashashi 2 , Y.  Hirooka 1
  • 1Department of Laboratory Medicine, Aichi Medical University, Aichi, Japan
  • 2Fourth Department of Internal Medicine, Aichi Medical University, Aichi, Japan
Further Information

Publication History

Received 31 January 2002

Accepted after revision 29 July 2002

Publication Date:
01 April 2003 (online)

Abstract

Aquaporin-2, a water-channel protein, is known to increase water permeability due to vasopressin binding to V2 receptors at the renal collecting duct and is excreted into the urine. It is still unclear whether a hyponatremic state is caused by vasopressin-dependent aquaporin-2 in patients clinically diagnosed with the syndrome of inappropriate secretion of antidiuretic hormone. To determine this, we measured urinary aquaporin-2 and vasopressin by radioimmunoassay in normonatremic or hyponatremic patients after cerebral infarction and in healthy controls. In the normonatremia group, urinary aquaporin-2 and plasma AVP levels were higher than in controls. In the hyponatremia group, plasma AVP was relatively high despite low plasma osmolality in each patient. However, urinary aquaporin-2 in hyponatremia was significantly increased when compared with the other two groups. In conclusion, AQP-2 increment does not directly reflect non-osmotic AVP secretion in a hyponatremic state. This result indicates that the urinary excretion of AQP-2 is not only AVP-dependent in hyponatremic states.

References

  • 1 Sasaki S, Fushimi K, Saito H, Saito F, Uchida S, Ishibashi K, Kuwahara M, Ikeuchi T, Inui K, Nakajima K, Watanabe T X, Marumo F. Cloning characterization and chromosomal mapping of human aquaporin of collecting duct.  J Clin Invest. 1994;  93 1250-1256
  • 2 Fushimi K, Uchida S, Hara Y, Hirata Y, Marumo F, Sasaki S. Cloning and expression of apical membrane water channel of rat kidney collecting tubule.  Nature. 1993;  361 549-552
  • 3 Hayashi M, Sasaki S, Tsuganezawa H, Monkawa T, Kitajima W, Konishi K, Fushimi K, Marumo F, Saruta T. Expression and distribution of aquaporin of collecting duct are regulated by vasopressin V2 receptor in rat kidney.  J Clin Invest. 1999;  94 1778-1783
  • 4 Hochberg Z, van Lieburg A, Even L, Brenner B, Lanir N, van Oost B A, Knoers N V. Autosomal recessive nephrogenic insipidus caused by aquaporin-2 mutation.  J Clin Endocr Metab. 1997;  82 686-689
  • 5 Deen P MT, Verdijk M AJ, Knoers N VAM, Wieringa B, Monnens L AH, van Os C H, van Oost B A. Requirement of human renal water channel aquaporin-2 for vasopressin-dependent concentration of urine.  Science. 1994;  264 92-95
  • 6 van Lieburg A F, Verdijk M AJ, Knoers N VAM, van Essen A J, Proesmans W, Mallmann R, Monnens L AH, van Oost B A, van Os C H, Deen P MT. Patients with autosomal nephrogenic diabetes insipidus homozygous for mutations in the aquaporin 2 water-channel gene.  Am J Hum Genet. 1994;  55 648-652
  • 7 Mulders S M, Bichet D G, Rijss J PL, Kamsteeg E-J, Françoise M-F, Lonergan M, Fujiwara M, Morgan K, Leijendekker R, van der Sluijs P, van Os C H, Deen P MT. An aquaporin-2 water channel mutant which causes autosomal dominant nephrogenic diabetes insipidus is retained in the Golgi complex.  J Clin Invest. 1998;  102 57-66
  • 8 Kanno K, Sasaki S, Hirata Y, Ishikawa S, Fushimi K, Nakanishi S , Bichet D G, Marumo F. Urinary excretion of AQP-2 in patients with diabetes insipidus.  New Engl J Med. 1995;  332 1540-1545
  • 9 Saito T, Ishikawa S, Sasaki S, Nakamura T, Rokkaku K, Kawakami A, Honda K, Marumo F, Saito T. Urinary excretion of aquaporin-2 in the diagnosis of central diabetes insipidus.  J Clin Endocr Metab. 1997;  82 1823-1827
  • 10 Fujita N, Ishikawa S, Sasaki S, Fujisawa G, Fushimi K, Marumo F, Saito T. Role of water channel AQP-CD in water retention in SIADH and cirrhotic rats.  Am J Physiol. 1995;  269 F926-931
  • 11 Xu L, Martin P-Y, Ohara M, John J, Pattison T, Meng X, Morris K, Kim J K, Schrier R W. Upregulation of aquaporin-2 water channel expression in chronic heart failure rat.  J Clin Invest. 1997;  99 1500-1505
  • 12 Murase T, Ecelbarger C A, Baker E A, Tian Y, Knepper M A, Verbalis J G. Kidney aquaporin-2 expression during escape from antidiuresis is not related to plasma or tissue osmolality.  J Am Soc Nephrol. 1999;  10 2067-2075
  • 13 Kamoi K, Toyama M, Ishibashi M, Yamaji T. Hyponatremia and osmotic regulation of vasopressin secretion in patients with intracranial bleeding.  J Clin Endocr Metab. 1995;  80 2906-2911
  • 14 Kamoi K, Toyoma M, Takagi M, Nishiyama K, Takahashi K, Sasaki H, Muto T. Osmoregulation of vasopressin secretion in patients with the syndrome of inappropriate antidiuresis associated with central nervous system disorders.  Endocr J. 1999;  46 269-277
  • 15 Schwartz W B, Bennett W, Curelop S, Bartter F C. A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone.  Am J Med. 1987;  23 529-542
  • 16 Mitsuma T, Takagi J, Otake K, Kayama Y, Adachi T, Nogimori T, Sakai J, Hirooka Y. Radioimmunoassay for aquaporin-2.  Endocr Regul. 1998;  32 141-144
  • 17 Rai T, Sekine K, Kanno K, Hata K, Miura M, Mizushima A, Marumo F, Sasaki S. Urinary excretion of aquaporin-2 water channel protein in human and rat.  J Am Soc Nephrol. 1997;  8 1357-1362
  • 18 Elliot S, Goldsmith P, Knepper M, Haughey M, Olsen B. Urinary excretion of aquaporin-2 in humans: A potential marker of collecting duct responsiveness to vasopressin.  J Am Soc Nephrol. 1996;  7 403-409
  • 19 Martin P-Y, Abraham W T, Xu L, Olson B R, Oren R M, Ohara M, Shrier R W. Selective V2-receptor vasopressin antagonism decreases urinary aquaporin-2 excretion in patients with chronic heart failure.  J Am Soc Nephrol. 1999;  10 2165-2170
  • 20 Olsson J-E, Forsling M L, Lindvall B, Åkerlund M. Cerebrospinal fluid arginine vasopressin in Parkinson's disease, dementia, and other degenerative disorders.  Adv Neurol. 1986;  45 239-242
  • 21 Joint R J, Feibel J H, Sladek C M. Antidiuretic hormone levels in stroke patients.  Ann Neurol. 1981;  9 182-184
  • 22 Zbigniew M R, Jolanta C M. Vasopressin concentration in the blood during acute short-term intracranial hypertension in cats.  Adv Neurol. 1978;  20 381-388
  • 23 Sørensen P S, Gjerris A, Hammer M. Cerebrospinal fluid vasopressin in neurological and psychiatric disorders.  J Neurol Neurosurg Psychiat. 1985;  48 50-57
  • 24 Gaufin L, Skowsky W R, Goodman S J. Release of antidiuretic hormone during mass-induced elevation of intracranial pressure.  J Neurosurg. 1977;  46 627-637
  • 25 Schrier R W, Berl T, Anderson R J. Osmotic and non-osmotic control of vasopressin release.  Am J Physiol. 1979;  236 F321-F332
  • 26 Saito T, Ishikawa S, Sasaki S, Fujita N, Fushimi K, Okada K, Takeuchi K, Sakamoto A, Ookawara S, Kaneko T, Marumo F, Saito T. Alteration in water channel AQP-2 by removal of AVP stimulation in collecting duct cells of dehydrated rats.  Am J Physiol. 1997;  272 F183-F191
  • 27 Nielsen S, Chou C-L, Marples D, Christensen E I, Kishore B K, Knepper M A. Vasopressin increases water permeability of kidney collecting duct by inducing translocation of aquaporin-CD water channels to plasma membrane.  Proc Natl Acad Sci USA. 1995;  92 1013-1017
  • 28 DiGiovanni S R, Nielsen S, Christensen E I, Knepper M A. Regulation of collecting duct water channel expression by vasopressin in Brattleboro rat.  Proc Natl Acad Sci USA. 1994;  91 8984-8988
  • 29 Saito T, Ishikawa S, Sasaki S, Higashiyama M, Nagasaki S, Fujita N, Fushimi K, Marumo F, Saito T. Lack of vasopressin upregulation of AQP-2 gene expression in homozygous Brattleboro rats.  Am J Physiol. 1999;  277 R427-433
  • 30 Wen H, Frøkiaer J, Kwon T H, Nielsen S. Urinary excretion of aquaporin-2 in rat is mediated by vasopressin-dependent apical pathway.  J Am Soc Nephrol. 1999;  10 1416-1429
  • 31 Baumgarten R, van de Pol M HJ, Deen P MT, van Os C H, Werzels J FM. Dissociation between urinary excretion of aquaporin-2 and vasopressin action in healthy volunteers.  J Am Nephrol Soc Abstract A0077. 1998;  9 15A
  • 32 Buemi M, Corica F, di Pasquale G, Aloisi C, Sofi M, Casuscelli T, Floccari F, Senatore M, Corsonello A, Frisina N. Water immersion increase urinary excretion of aquaporin-2 in healthy humans.  Nephron. 2000;  85 20-26
  • 33 Conte G, Bellizzi V, Cianciaruso B, Minutolo R, Fuiano G, de Nicola L. Physiologic role and diuretic efficacy of atrial natriuretic peptide in health and chronic renal disease.  Kidney Int. 1997;  51 S28-32
  • 34 Nonoguchi H, Sands J M, Knepper M A. Atrial natriuretic factor inhibits vasopressin-stimulated osmotic water permeability in rat inner medullary collecting duct.  J Clin Invest. 1988;  88 1383-1390
  • 35 Naruse S, Aoki Y, Takei R, Horikawa Y, Ueda S. Effect of atrial natriuretic peptide on ischemic brain edema in rats evaluated by proton magnetic resonance method.  Stroke. 1991;  22 61-65
  • 36 Estrada V, Tellez M J, Moya J, Fernandez-Durango R, Egido J, Cruz A F. High plasma levels of endothelin-1 and atrial natriuretic peptide in patients with acute ischemic stroke.  Am J Hypertension. 1994;  7 1085-1089
  • 37 Weinand M E, O'Boynick P L, Goetz K L. A study of serum antidiuretic hormone and atrial natriuretic peptide levels in series of patients with intracranial disease and hyponatremia.  Neurosurgery. 1989;  25 781-785
  • 38 Kamoi K, Ebe T, Kobayashi O, Ishida M, Sato F, Arai O, Tamura T, Takagi A, Yamada A, Ishibashi M, Yamaji T. Atrial natriuretic peptide in patients with the syndrome of inappropriate antidiuretic hormone secretion and with diabetes insipidus.  J Clin Endocrinol Metab. 1990;  70 1385-1390
  • 39 Frigeri A, Gropper M A, Umenishi F, Kawashima M, Brown D, Verkman A S. Localization of MIWC and GLIP water channel homologs in neuromuscular, epithelial, and glandular tissues.  J Cell Sci. 1995;  108 2993-3002
  • 40 Terris J, Ecelbarger C A, Nielsen S, Knepper M A. Long-term regulation of four renal aquaporins in rats.  Am J Physiol. 1996;  271 F414-422
  • 41 Ecelbarger C A, Terris J, Frindt G, Echevarria M, Marples D, Nielsen S, Knepper M A. Aquaporin-3 water channel localization and regulation in rat kidney.  Am J Physiol. 1995;  269 F663-672
  • 42 Fernandez-Llama P, Turner R, Dibona G, Knepper M A. Renal expression of aquaporins in liver cirrhosis induced by chronic common bile duct ligation in rats.  J Am Soc Nephrol. 1999;  10 1950-1957
  • 43 Tsuboi Y, Ishikawa S, Fujisawa G, Okada K, Saito T. Therapeutic efficacy of the non-peptide AVP antagonist OPC-31 260 in cirrhotic rats.  Kidney Int. 1994;  46 237-244
  • 44 O'Neill P A, Davies I, Fullerton K J, Bennett D. Fluid balance in elderly patients following acute stroke.  Age Ageing. 1992;  21 280-285
  • 45 Ayus J C, Krothapalli R, Arieff A I. Treatment of symptomatic hyponatremia and its relation to brain damage.  New Engl J Med. 1987;  317 1190-1195

J. Takagi

Department of Laboratory Medicine · Aichi Medical University ·

21-Karimata, Nagakute · Aichi 480-1195 · Japan ·

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Email: jutakagi@aichi-med-u.ac.jp