Exaggerated natriuresis in adult polycystic kidney disease

Acta Med Scand. 1986;219(1):59-66. doi: 10.1111/j.0954-6820.1986.tb03276.x.


Angiotensin II (AII), aldosterone (Aldo) arginine vasopressin (AVP) in plasma, serum osmolality (Sosm), and renal sodium excretion (UNaV) were studied before and after infusion of hypertonic sodium chloride solution in 20 patients with adult polycystic kidney disease (PKD) with normal or moderately reduced creatinine clearance (Ccr) and in 10 healthy control subjects. UNaV increased after sodium loading in all, significantly more in the PKD patients. AII and Aldo were normal before sodium loading and suppressed after saline in PKD patients and controls. The increase in VNaV correlated with Aldo in patients but not in controls. AVP before loading was increased in hypertensive PKD patients with reduced Ccr, but not in normotensive patients with normal Ccr. After hypertonic saline, Sosm increased to the same degree both in PKD and control subjects, but AVP increased more in those with PKD. The exaggerated natriuresis of PKD is probably not explained by a change in the activity of the renin-angiotensin-aldosterone system. The enhanced response of AVP to osmotic stimuli in PKD may be a compensatory reaction to a reduced renal tubular effect of AVP.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aldosterone / urine
  • Angiotensin II / blood
  • Arginine Vasopressin / blood
  • Blood Pressure / drug effects
  • Creatinine / urine
  • Female
  • Humans
  • Male
  • Middle Aged
  • Natriuresis* / drug effects
  • Osmolar Concentration
  • Polycystic Kidney Diseases / physiopathology*
  • Renin-Angiotensin System / drug effects
  • Saline Solution, Hypertonic / pharmacology
  • Sodium / urine


  • Saline Solution, Hypertonic
  • Angiotensin II
  • Arginine Vasopressin
  • Aldosterone
  • Sodium
  • Creatinine