Vasopressin: a novel target for the prevention and retardation of kidney disease?

After several decades during which little attention was paid to fluid intake vasopressin and/or urine concentration in clinical practice, interest in vasopressin has renewed with the availability of new, potent, orally active vasopressin-receptor antagonists—the vaptans—and with the results of epidemiological studies evaluating copeptin (a surrogate marker of vasopressin) in large population-based cohorts.

Key findings

Several experimental studies in rats and mice over the past 20 years have shown that, in addition to its positive action on water conservation, vasopressin, acting via vasopressin V2 antidiuretic receptors, contributes to the progression of chronic kidney disease; in particular, to autosomal dominant polycystic kidney disease. New epidemiological studies now suggest a role for vasopressin in the pathogenesis of diabetes mellitus and metabolic disorders via activation of hepatic V1a and/or pancreatic islet V1b receptors. The first part of this Review describes the adverse effects of vasopressin, as revealed by clinical and experimental studies in kidney diseases, hypertension, diabetes and the metabolic syndrome. The second part provides insights into vasopressin physiology and pathophysiology that may be relevant to the understanding of these adverse effects and that are linked to the excretion of concentrated nitrogen wastes and associated hyperfiltration.

Lise Bankir, Ph. D., is Directeur de Recherche Emeritus at INSERM, Centre de Recherche des Cordeliers, Paris, France. Lise Bankir has published 110 original papers and 30 invited reviews in peer-reviewed journals, and several book chapters. In 2011, she received the Berliner Award from the American Physiological Society and the Collery Award from the French National Academy of Medecine

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Last modified on Friday, 28 March 2014 13:43

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