Abstract
AVP, measured by radioimmunoassay, was studied in relation to plasma and urine osmolality (Posm and Uosm) in 90 controls (0-15 yrs), in 19 polyuric children, and in 48 patients with various medical problems. In controls AVP was significantly elevated in the first week of life (14.6±6.5 pg/ml,M±SD), while AVP did not change with age in older children (3.1±2.0 pg/ml). In adults slightly lower AVP levels were found (2.1±1.5 pg/ml). After 14-18 hrs of water deprivation in clinical trials serving as controls AVP increased (5.3±2.7 pg/ml), but no correlation between Posm and AVP was observed. In complete or partial central diabetes insipidus (n:7) AVP was undetectable or an inadequate rise after dehydration was found. AVP was highly elevated ( >10 pg/ml) and Uosm was low in renal diabetes insipidus (n:2) and in tubular disorders (n:10). Extrarenal fluid loss, e.g. in gastroenteritis (n:7) and burns (n:4), resulted in an increase of AVP and Uosm. In cardiovascular shock, sepsis, and severe stress (n:18) AVP was raised although no disturbance of water balance was apparent. Conclusions: 1) Measurement of AVP in combination with Posm and Uosm is of diagnostic value in the differentiation of polyuric states. 2) Nonosmotic factors play an important role in the regulation of AVP in childhood.
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Rauh, W., Huber, K. & Rascher, W. Diagnostic value and regulation of plasma arginine vasopressin (AVP) in childhood. Pediatr Res 15, 1539 (1981). https://doi.org/10.1203/00006450-198112000-00023
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DOI: https://doi.org/10.1203/00006450-198112000-00023