Central role of vasopressin in sodium/water retention in hypo- and hypervolemic nephrotic patients: A unifying hypothesis

Carla Sala, Valeria Bedogna, Linda Gammaro, Enrico Valvo, Alberto Del Bo, Alberto Morganti

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

The underfill and overflow hypotheses are usually held as mutually exclusive mechanisms for explaining sodium/water retention in nephrotic syndrome, but neither of them is entirely convincing. In this paper, we will briefly summarize the experimental and clinical evidence in favor of and against each hypothesis. Based on our personal observations, we propose a unifying hypothesis in which underfill and overflow are subsequent stages of the disease. In the transition, a central role is played by vasopressin, which is secreted in the two phases, respectively, by a volume and an osmotic stimulus; therefore, persistent sodium/water retention is maintained through the vascular and tubular effects of this peptide. In addition, we propose that vasodilation and sodium/water excretion could ensue when both stimuli for vasopressin release fade away, leading to the resolution of the syndrome.

Original languageEnglish
Pages (from-to)653-657
Number of pages5
JournalJournal of Nephrology
Volume17
Issue number5
Publication statusPublished - Sep 2004

Fingerprint

Hypovolemia
Vasopressins
Sodium
Water
Nephrotic Syndrome
Vasodilation
Blood Vessels
Peptides

Keywords

  • Atrial natriuretic peptide
  • Intravascular volume
  • Nephrotic syndrome
  • Renin-angiotensin system
  • Sodium/water retention
  • Systemic vasoconstriction
  • Vasopressin

ASJC Scopus subject areas

  • Nephrology

Cite this

Sala, C., Bedogna, V., Gammaro, L., Valvo, E., Del Bo, A., & Morganti, A. (2004). Central role of vasopressin in sodium/water retention in hypo- and hypervolemic nephrotic patients: A unifying hypothesis. Journal of Nephrology, 17(5), 653-657.

Central role of vasopressin in sodium/water retention in hypo- and hypervolemic nephrotic patients : A unifying hypothesis. / Sala, Carla; Bedogna, Valeria; Gammaro, Linda; Valvo, Enrico; Del Bo, Alberto; Morganti, Alberto.

In: Journal of Nephrology, Vol. 17, No. 5, 09.2004, p. 653-657.

Research output: Contribution to journalArticle

Sala, C, Bedogna, V, Gammaro, L, Valvo, E, Del Bo, A & Morganti, A 2004, 'Central role of vasopressin in sodium/water retention in hypo- and hypervolemic nephrotic patients: A unifying hypothesis', Journal of Nephrology, vol. 17, no. 5, pp. 653-657.
Sala, Carla ; Bedogna, Valeria ; Gammaro, Linda ; Valvo, Enrico ; Del Bo, Alberto ; Morganti, Alberto. / Central role of vasopressin in sodium/water retention in hypo- and hypervolemic nephrotic patients : A unifying hypothesis. In: Journal of Nephrology. 2004 ; Vol. 17, No. 5. pp. 653-657.
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