A defect in urine-concentrating ability is discernable in patients with autosomal dominant polycystic kidney disease (ADPKD) before any decline in glomerular filtration rate, and is associated with elevated concentrations of vasopressin and copeptin. This defect is 'urea-selective' and accordingly, the urine-to-plasma ratio of urea concentration could be a clinically relevant early marker of renal dysfunction in patients with ADPKD.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Meijer, E., Boertien, W. E., Zietse, R. & Gansevoort, R. T. Potential deleterious effects of vasopressin in chronic kidney disease and particularly autosomal dominant polycystic kidney disease. Kidney Blood Press. Res. 34, 235–244 (2011).
Zittema, D. et al. Vasopressin, copeptin, and renal concentrating capacity in patients with autosomal dominant polycystic kidney disease without renal impairment. Clin. J. Am. Soc. Nephrol. 7, 906–913 (2012).
Ho, T. A. et al. Autosomal dominant polycystic kidney disease is associated with central and nephrogenic defects in osmoregulation. Kidney Int. (in press).
Fenton, R. A. Urea transporters and renal function: lessons from knockout mice. Curr. Opin. Nephrol. Hypertens. 17, 513–518 (2008).
Yang, B. & Bankir, L. Urea and urine concentrating ability: new insights from studies in mice. Am. J. Physiol. Renal Physiol. 288, F881–F896 (2005).
Bankir, L. & Yang, B. New insights into urea and glucose handling by the kidney, and the urine concentrating mechanism. Kidney Int. 81, 1179–1198 (2012).
Schlondorff, D. Renal prostaglandin synthesis. Sites of production and specific actions of prostaglandins. Am. J. Med. 81, 1–11 (1986).
Corey, H. E., Greifer, I., Greenstein, S. M., Tellis, V. & Spitzer, A. The fractional excretion of urea: a new diagnostic test for acute renal allograft rejection. Pediatr. Nephrol. 7, 268–272 (1993).
Miller, T. R. et al. Urinary diagnostic indices in acute renal failure: a prospective study. Ann. Intern. Med. 89, 47–50 (1978).
Bae, K. T. & Grantham, J. J. Imaging for the prognosis of autosomal dominant polycystic kidney disease. Nat. Rev. Nephrol. 6, 96–106 (2010).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
D. G. Bichet has worked as a consultant for Otsuka Pharmaceutical and received speakers bureau honoraria and grant/research support from Otsuka Pharmaceutical. L. Bankir declares no competing interests.
Rights and permissions
About this article
Cite this article
Bankir, L., Bichet, D. An early urea-selective urine-concentrating defect in ADPKD. Nat Rev Nephrol 8, 437–439 (2012). https://doi.org/10.1038/nrneph.2012.139
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrneph.2012.139
