[Hormones and hemodynamics in edematous diseases]

Clinical and laboratory experiments have demonstrated that arginine vasopressin (AVP), renin-aldosterone system and catecholamines play a crucial role in water and sodium retention in edematous diseases, including congestive heart failure, nephrotic syndrome and liver cirrhosis. These hormonal secretions are all increased mediated through baroreceptor mediated afferent pathway, in which the tonic inhibition of hormonal release is attenuated by decreased effective circulatory blood volume. Increased plasma hormones augment their action in renal tubules. AVP increases abundance of aquaporin-2 protein in renal collecting duct cells, and enhances renal water reabsorption. Aldosterone enhances sodium reabsorption in distal nephron. Also, norepinephrine increases sodium reabsorption in proximal tubules, and in part augments renin-aldosterone system that increases sodium reabsorption in distal nephron.