Abstract:
Arginine vasopressin (AVP) has a key role in osmoregulation by facilitating water transport in the collecting duct. Recent evidence suggests that AVP may have additional effects on renal function and favor cyst growth in polycystic kidney disease. Whether AVP also affects kidney structure in the general population is unknown. We analyzed the association of copeptin, an established surrogate for AVP, with parameters of renal function and morphology in a multicentric population-based cohort. Participants from families of European ancestry were randomly selected in three Swiss cities. We used linear multilevel regression analysis to explore the association of copeptin with renal function parameters as well as kidney length and the presence of simple renal cysts assessed by ultrasound examination. Copeptin levels were log-transformed. The 529 women and 481 men had median copeptin levels of 3.0 and 5.2 pmol/L, respectively (P<0.001). In multivariable analyses, the copeptin level was associated inversely with eGFR (β=-2.1; 95% confidence interval [95% CI], -3.3 to -0.8; P=0.002) and kidney length (β=-1.2; 95% CI, -1.9 to -0.4; P=0.003) but positively with 24-hour urinary albumin excretion (β=0.11; 95% CI, 0.01 to 0.20; P=0.03) and urine osmolality (β=0.08; 95% CI, 0.05 to 0.10; P<0.001). A positive association was found between the copeptin level and the presence of renal cysts (odds ratio, 1.6; 95% CI, 1.1 to 2.4; P=0.02). These results suggest that AVP has a pleiotropic role in renal function and may favor the development of simple renal cysts.
摘要:
精氨酸加压素(AVP)通过促进集管中的水运输在渗透调节中起关键作用。最近的证据表明,AVP可能对肾功能有额外的影响,并有利于多囊肾疾病的囊肿生长。AVP是否也影响一般人群的肾脏结构尚不清楚。我们分析了和肽素的关联,AVP的既定代理人,多中心人群队列中的肾功能和形态学参数。来自欧洲血统家庭的参与者是在三个瑞士城市随机选择的。我们使用线性多水平回归分析来探讨和肽素与肾功能参数以及肾脏长度以及通过超声检查评估的单纯性肾囊肿的存在的关系。和肽素水平是对数转化的。529名女性和481名男性的中位数和肽素水平分别为3.0和5.2pmol/L,分别(P<0.001)。在多变量分析中,和肽素水平与eGFR呈负相关(β=-2.1;95%置信区间[95%CI],-3.3至-0.8;P=0.002)和肾脏长度(β=-1.2;95%CI,-1.9至-0.4;P=0.003),但24小时尿白蛋白排泄(β=0.11;95%CI,0.01至0.20;P=0.03)和尿渗透压(β=0.08;95%CI,0.05至0.10;P<0.001)。发现和肽素水平与肾囊肿的存在之间存在正相关(比值比,1.6;95%CI,1.1至2.4;P=0.02)。这些结果表明,AVP在肾功能中具有多效作用,可能有利于单纯性肾囊肿的发展。