Assessment of hormonal disorders of water metabolism.

Clinical disorders of water regulation are relatively common and occur with severity ranging from profound and easily recognizable disturbance of body water balance to mild and often clinically inapparent. The development of sensitive and specific radioimmunoassay procedures capable of quantitating the level of AVP in plasma and urine has allowed elucidation of the pathophysiology of [...]

The clinical physiology of water metabolism. Part III: The water depletion (hyperosmolar) and water excess (hyposmolar) syndromes.

Hyperosmolality occurs when there are defects in the two major homeostatic mechanisms required for water balance-thirst and arginine vasopressin (AVP) release. In this situation hypotonic fluids are lost in substantial quantities causing depletion of both intracellular and extracellular fluid compartments. Patients with essential hypernatremia have defective osmotically stimulated AVP release and thirst but may have [...]

The clinical physiology of water metabolism. Part II: Renal mechanisms for urinary concentration; diabetes insipidus.

The renal reabsorption of water independent of solute is the result of the coordinated function of the collecting duct and the ascending limb of the loop of Henle. The unique juxtaposition of the ascending and descending portions of the loop of Henle and of the vasa recta permits the function of a counter-current multiplier system [...]

The clinical physiology of water metabolism. Part I: The physiologic regulation of arginine vasopressin secretion and thirst.

Water balance is tightly regulated within a tolerance of less than 1 percent by a physiologic control system located in the hypothalamus. Body water homeostasis is achieved by balancing renal and nonrenal water losses with appropriate water intake. The major stimulus to thirst is increased osmolality of body fluids as perceived by osmoreceptors in the [...]

Water channels.

The movement of water across cell membranes has been an active area of research for more than 100 years and is of fundamental importance in the normal water metabolism of all terrestrial animals. The objective of this review is to integrate recent data obtained from the isolation and molecular cloning of water channel proteins, with [...]

Physiology and pathophysiology of the vasopressinergic system.

Arginine vasopressin, a hypothalamic peptide hormone, has multiple physiological functions, including body water regulation, control of blood pressure and effects on body temperature, insulin release, corticotropin release, memory and social behaviour. These functions are achieved via at least three specific G-protein-coupled vasopressin receptors. Development of specific vasopressin receptor antagonists in recent years is helping to [...]

Aquaporin-related disorders of water homeostasis.

The discovery of four major water channels in the kidney, namely aquaporins (AQP) 1, 2, 3 and 4, has allowed a substantial increase in our understanding of renal water regulation in health and disease. This review discusses the renal aquaporin water channels in the urinary dilution and concentrating defects in cardiac failure, cirrhosis, syndrome of [...]

Unifying hypothesis of sodium and water regulation in health and disease.

Sodium and water retention is characteristic of edematous disorders including cardiac failure, cirrhosis, nephrotic syndrome, and pregnancy. Nonosmotic vasopressin release has been implicated in the water retention of these edematous disorders. The nonosmotic release of vasopressin is consistently associated with activation of the sympathetic nervous and renin-angiotensin-aldosterone systems in both experimental animals and in edematous [...]