deamino-arginine-vasopressin and Ischemia

The aim of the present experiment was to test whether vasopressin modulates pain perception in man. Twenty-four male volunteers participated in four sessions, each 2 weeks apart. After an adaptation session the subjects were treated intranasally with either 30 or 60 micrograms desmopressin (DDAVP) or placebo according to a cross-over double-blind design. Pain induction involved mechanical, thermal, and ischemic stimulation DDAVP had no unitary effects on pain perception in the different pain tests. The 30 micrograms dose induced sensitization to thermal stimuli. Neither treatment influenced ischemic pain perception. The mechanical pain threshold of the index finger was increased by the 60 micrograms dose only. After treatment with either dosage of DDAVP the subjects generally tolerated the pressure on their index finger for a longer time than after placebo treatment.

Topics: Administration, Intranasal; Adrenocorticotropic Hormone; Adult; Arm; Blood Pressure; Cross-Over Studies; Deamino Arginine Vasopressin; Dose-Response Relationship, Drug; Double-Blind Method; Hot Temperature; Humans; Hydrocortisone; Ischemia; Male; Pain; Pain Measurement; Perception

Polyuria in post-kidney transplant (KT) patients is a common condition generally attributed to delayed tubular function, fluid administration, and solute diuresis. Since excessive water intake post-KT physiologically suppresses arginine vasopressin (AVP) secretion, central diabetes insipidus (CDI) caused by deficient primary AVP release can be overlooked. Although DDAVP (desmopressin) - a selective AVP V2 receptor agonist - has been used to treat massive polyuria, CDI rarely progresses to kidney injury due to the preservation of fluid balance by thirst-dependent osmoregulation. Administration of DDAVP in post-KT recipients with mild polyuria and subclinical CDI is difficult to assess, and whether long-term use of DDAVP is beneficial for the transplanted kidney has not been established. We present the case of a 36-year-old Japanese female who was diagnosed with subclinical/partial CDI post KT. CDI was caused by a sequela of suprasellar germinoma. Graft function gradually declined without evidence of hypovolemia or hypernatremia, and a kidney biopsy revealed advanced ischemic kidney injury. Although daily oral DDAVP administration did not increase extracellular fluid volume, treatment resulted in a gradual improvement of graft function, and a follow-up transplanted kidney biopsy indicated substantial recovery.

Topics: Administration, Oral; Adult; Deamino Arginine Vasopressin; Diabetes Insipidus, Neurogenic; Female; Humans; Ischemia; Kidney; Kidney Transplantation

The effect of 60 min of ischaemia on glomerular and tubular functions (osmolar clearance, fractional Na+ excretion, K+ clearance, concentrating ability) after different periods of time was studied in New Zealand White rabbits. Pronounced changes in both glomerular and tubular functions were observed immediately on reperfusion and after 48 h. One week after ischaemia the functions appeared to be normalized. Mannitol is routinely used in clinical kidney transplantation due to its hyperosmolar effects and its ability to scavenge the hydroxyl radical. In the present study the possible additive protective effect against ischaemia-reperfusion damage of a combined pretreatment with mannitol and oxygen free radical scavengers or mannitol and a xanthine oxidase inhibitor was examined. Oxypurinol was chosen as the xanthine oxidase inhibitor due to its direct inhibitory effect. Concerning glomerular function, no protective effect of the combined pretreatment compared with mannitol alone was observed. However, concerning the tubular function tests combined pretreatment with either mannitol-superoxide dismutase-catalase or mannitol-oxypurinol turned out to be superior compared with that of mannitol alone.

Topics: Animals; Catalase; Creatinine; Deamino Arginine Vasopressin; Ischemia; Kidney; Kidney Tubules; Mannitol; Oxypurinol; Potassium; Rabbits; Sodium; Superoxide Dismutase