Changes in Plasma Copeptin Levels during Hemodialysis: Are the Physiological Stimuli Active in Hemodialysis Patients?

Plasma levels of copeptin, a surrogate marker for the vasoconstrictor hormone arginine vasopressin (AVP), are increased in hemodialysis patients. Presently, it is unknown what drives copeptin levels in hemodialysis patients. We investigated whether the established physiological stimuli for copeptin...

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Bibliographic Details
Published in:PloS one 2015-05, Vol.10 (5), p.e0127116-e0127116
Main Authors: Ettema, Esmée M, Kuipers, Johanna, Assa, Solmaz, Bakker, Stephan J L, Groen, Henk, Westerhuis, Ralf, Gaillard, Carlo A J M, Gansevoort, Ron T, Franssen, Casper F M
Format: Article
Language:English
Subjects:
Aged
Argipressin
Blood
Blood Pressure
Blood Volume
Cardiovascular disease
Dependent variables
Diabetes mellitus
Dialysis
Female
Glycopeptides - blood
Health aspects
Hemodialysis
Humans
Hypertension
Internal medicine
Kidney diseases
Male
Medicine
Middle Aged
Mortality
Multivariate analysis
Natriuretic Peptide, Brain - blood
Nephrology
Osmolar Concentration
Patients
Peptide Fragments - blood
Peptides
Physiological aspects
Physiology
Plasma levels
Renal Dialysis
Sepsis
Sodium
Sodium - blood
Stimuli
Ultrafiltration
Vasopressin
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Summary:Plasma levels of copeptin, a surrogate marker for the vasoconstrictor hormone arginine vasopressin (AVP), are increased in hemodialysis patients. Presently, it is unknown what drives copeptin levels in hemodialysis patients. We investigated whether the established physiological stimuli for copeptin release, i.e. plasma osmolality, blood volume and mean arterial pressure (MAP), are operational in hemodialysis patients. One hundred and eight prevalent, stable hemodialysis patients on a thrice-weekly dialysis schedule were studied during hemodialysis with constant ultrafiltration rate and dialysate conductivity in this observational study. Plasma levels of copeptin, sodium, MAP, and blood volume were measured before, during and after hemodialysis. Multivariate analysis was used to determine the association between copeptin (dependent variable) and the physiological stimuli plasma sodium, MAP, excess weight as well as NT-pro-BNP immediately prior to dialysis and between copeptin and changes of plasma sodium, MAP and blood volume with correction for age, sex and diabetes during dialysis treatment. Patients were 63 ± 15.6 years old and 65% were male. Median dialysis vintage was 1.6 years (IQR 0.7-4.0). Twenty-three percent of the patients had diabetes and 82% had hypertension. Median predialysis copeptin levels were 141.5 pmol/L (IQR 91.0-244.8 pmol/L). Neither predialysis plasma sodium levels, nor NT-proBNP levels, nor MAP were associated with predialysis copeptin levels. During hemodialysis, copeptin levels rose significantly (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0127116