Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Reversible vasopressin deficiency in severe hypernatremia

C R Cooke1, B M Wall, G V Jones

  • 1Department of Medicine, Veterans Affairs Medical Center, Memphis, TN 38104.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|July 1, 1993
PubMed
Summary

This study found that plasma arginine vasopressin (Pavp) levels were inappropriately low in an elderly patient with severe hypernatremia, despite high plasma osmolality (Posm). The patient

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Spatial and temporal variability of cv. Tempranillo phenology and grape quality within the Ribera del Duero DO (Spain) and relationships with climate.

International journal of biometeorology·2015
Same author

Encoding origin of the terminal asymmetry effect in recall.

Memory & cognition·2013
Same author

Developmental parameters and seasonal phenology of Calepitrimerus vitis (Acari: Eriophyidae) in wine grapes of western Oregon.

Environmental entomology·2011
Same author

Determining the optimal method for proteinuria detection in chronic spinal cord injury.

Spinal cord·2011
Same author

Patterns of injury in mycophenolate mofetil-related colitis.

Transplantation proceedings·2010
Same author

Automatic laser tracking and ranging system.

Applied optics·2010

Area of Science:

  • Endocrinology and Metabolism
  • Nephrology
  • Geriatric Medicine

Background:

  • Severe hypernatremia can occur in elderly patients, particularly those with cognitive impairment and reduced fluid intake.
  • Arginine vasopressin (AVP) plays a crucial role in regulating water balance and plasma osmolality (Posm).
  • The relationship between plasma arginine vasopressin concentration (Pavp) and Posm is typically well-established in healthy individuals.

Observation:

  • An elderly patient with dementia and a hip fracture presented with severe hypernatremia (serum sodium 174-196 mEq/L).
  • During hypernatremia correction, Pavp was found to be low and correlated with Posm (r = 0.887), but blunted relative to the degree of hyperosmolality and volume depletion.
  • Subsequent hypertonic saline infusions showed a delayed and exaggerated AVP response, eventually normalizing to levels seen in healthy subjects.

Related Experiment Videos

Findings:

  • The patient exhibited an impaired AVP response to hyperosmolality and volume depletion during the initial hypernatremic episode.
  • The osmoreceptor-AVP axis appeared to be reset or desensitized in this patient.
  • Following correction of hypernatremia, the AVP response to osmotic challenge gradually recovered, suggesting a potentially reversible impairment.

Implications:

  • This case highlights the potential for impaired AVP secretion in elderly patients with severe hypernatremia, contributing to the development and severity of the condition.
  • Understanding the dynamics of AVP regulation in such patients is critical for appropriate fluid and electrolyte management.
  • Further research into the mechanisms of AVP dysregulation in elderly individuals with cognitive impairment and dehydration is warranted.