Renal vasodilatory action of arginine vasopressin in extremely low birth weight infants

Maiko Kaga, Tadashi Matsuda, Tatsuya Watanabe, Sachiko Onodera, Shinpei Watanabe, Haruo Usuda, Satoko Ito

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

In extremely low birth weight (ELBW) infants, systemic hypotension is associated with poor neurological outcomes as a result of cerebral hypoperfusion. Treatment with arginine vasopressin (AVP) has been shown to increase blood pressure (BP) and urine output in ELBW infants suffering from refractory hypotension. The purpose of this study was to clarify whether low doses of AVP increased renal blood flow (RBF) in ELBW infants. We retrospectively analyzed data from the medical charts describing nine AVP infusions at 0.3-0.8 mU/kg/min in four ELBW infants. The median gestational age was 23 (22.5-23.5, interquartile range) weeks, and the median birth weight was 466 (414-563) g. Changes in the heart rate, BP, urine output, and RBF velocity patterns in response to the AVP infusions were compared using statistical analyses. The AVP infusion caused significant increases in systolic BP from 44 (41.0-47.0) to 50 (42.5-55.5) mmHg, diastolic BP from 17 (15.0-26.5) to 31 (28.5-33.0) mmHg, mean BP from 26 (24.5-30.5) to 36 (34.5-40.5) mmHg, and urine output from 1.4 (0.2-2.5) to 2.8 (1.0-8.6) mL/kg/hr. We also observed significant decreases in the resistance index from 1.0 (0.96-1.0) to 0.8 (0.71-0.91) and peak systolic flow velocity in the renal artery from 40 (27.2-50.6) to 28 (16.0-28.9) cm/s after AVP infusions. AVP infusions a 0.3-0.8 mU/kg/min in ELBW infants appeared to significantly increase the RBF by inducing renal vascular dilation and increasing the BP. Increasing the RBF most likely induces an increase in the glomerular filtration rate, resulting in the diuretic effect of AVP.

Original languageEnglish
Pages (from-to)159-164
Number of pages6
JournalTohoku Journal of Experimental Medicine
Volume231
Issue number3
DOIs
Publication statusPublished - 2013 Nov 6

Keywords

  • Arginine vasopressin
  • Diuretic effect
  • Extremely low birth weight infants
  • Renal blood flow
  • Renal vasodilation

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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    Kaga, M., Matsuda, T., Watanabe, T., Onodera, S., Watanabe, S., Usuda, H., & Ito, S. (2013). Renal vasodilatory action of arginine vasopressin in extremely low birth weight infants. Tohoku Journal of Experimental Medicine, 231(3), 159-164. https://doi.org/10.1620/tjem.231.159