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Vasopressin beyond water: implications for renal diseases

Bolignano, Davide; Zoccali, Carmine

Current Opinion in Nephrology and Hypertension: September 2010 - Volume 19 - Issue 5 - p 499–504
doi: 10.1097/MNH.0b013e32833d35cf
Special commentary

Purpose of review This review aims to analyze the relationships between arginine vasopressin (AVP) and chronic kidney disease (CKD) and to define the potential of vasopressin receptor antagonists beyond the treatment of water metabolism disorders.

Recent findings Experimental studies in rat and observational studies in humans suggest that AVP may play a role in the genesis and exacerbation of renal damage and chronic renal insufficiency.

Summary A sustained stimulation of vasopressin receptors induces intrarenal renin–angiotensin system activation, podocyte alterations, glomerular hyperfiltration and hypertrophy eventuating in proteinuria and kidney damage. Furthermore, AVP directly stimulates contraction and proliferation of mesangial cells and accumulation of extracellular matrix and glomerulosclerosis. Whether a chronic increase in water intake (determining a reduction in endogenous AVP levels) and/or the administration of vasopressin receptor antagonists are useful for the prevention and treatment of CKD remains to be tested in clinical trials.

CNR-IBIM, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, Reggio Calabria, Italy

Correspondence to Professor Carmine Zoccali, Nephrology, Hypertension and Renal Transplantation, CNR-IBIM Clinical Epidemiology of Renal Diseases and Hypertension, Ospedali Riuniti, Reggio Calabria, Italy Tel: +39 0965 397010; e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.