Document Detail

1-Desamino-8-D-arginine vasopressin (DDAVP) in patients with congenital nephrogenic diabetes insipidus.
MedLine Citation:
PMID:  8232694     Owner:  NLM     Status:  MEDLINE    
In healthy subjects, intravenous infusion of the selective V2-vasopressin receptor agonist 1-desamino-8-D-arginine vasopressin (DDAVP, 400 ng/kg in 10 min) causes a marked increase in heart rate with a slight decrease in diastolic blood pressure. These haemodynamic responses are associated with increments in the plasma levels of renin, noradrenaline (NA), clotting factor VIII (FVIII:C), von Willebrand factor (vWF:ag), and tissue-type plasminogen activator (t-PA), and a fall in the plasma level of plasminogen activator inhibitor (PAI). None of these changes was observed in 3 patients with congenital nephrogenic diabetes insipidus (NDI), who had a genetic defect of the V2-receptor. Plasma AVP levels in these patients were normal or slightly elevated, which makes it unlikely that the lack of DDAVP responsiveness was caused by down-regulation of vasopressin V1-receptors. In one NDI patient, arginine vasopressin (AVP) was given in incremental doses (62.5-4000 pg/kg/min). The heart rate and blood pressure responses to AVP were normal, indicating the absence of a V1-receptor defect. The responses of vWF:ag and t-PA to venous occlusion in the patients with NDI were similar to those in 5 healthy volunteers, which indicates that in NDI the endothelial release of both vWF:ag and t-PA is normal. We conclude that DDAVP causes its effects on heart rate and blood pressure, and on the plasma levels of renin, noradrenaline, FVIII:C, vWF:ag, and t-PA through V2-receptor stimulation.
H S Brink; F H Derkx; F Boomsma; E J Brommer; M A Schalekamp
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Publication Detail:
Type:  Case Reports; Clinical Trial; Journal Article    
Journal Detail:
Title:  The Netherlands journal of medicine     Volume:  43     ISSN:  0300-2977     ISO Abbreviation:  Neth J Med     Publication Date:  1993 Aug 
Date Detail:
Created Date:  1993-12-06     Completed Date:  1993-12-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0356133     Medline TA:  Neth J Med     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  5-12     Citation Subset:  IM    
Department of Internal Medicine I, Erasmus University, Rotterdam, Netherlands.
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MeSH Terms
Blood Coagulation / drug effects*
Deamino Arginine Vasopressin / pharmacology*
Diabetes Insipidus / blood,  congenital*,  drug therapy*,  physiopathology
Factor VIII / analysis
Fibrinolysis / drug effects*
Hemodynamics / drug effects*
Infusions, Intravenous
Norepinephrine / blood
Plasminogen Inactivators / blood
Receptors, Vasopressin / drug effects,  genetics
Renin / blood
Tissue Plasminogen Activator / blood
von Willebrand Factor / analysis
Reg. No./Substance:
0/Plasminogen Inactivators; 0/Receptors, Vasopressin; 0/von Willebrand Factor; 16679-58-6/Deamino Arginine Vasopressin; 51-41-2/Norepinephrine; 9001-27-8/Factor VIII; EC Plasminogen Activator; EC

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