Puberty alters renal water handling
Published online on October 30, 2013
Abstract
We investigated the influence of sex and puberty stage on the circadian urine production and levels of antidiuretic hormone (AVP) in healthy children. Thirty-nine volunteers (9 prepuberty boys, 10 prepuberty girls, 10 midpuberty boys and 10 midpuberty girls) were included. All participants underwent a 24-hours circadian in-patient study under standardized conditions regarding sodium and fluid intake. Blood samples were drawn every four hours for measurements of plasma AVP, serum 17-β-estradiol and testosterone and the urine was fractionally collected for measurements of electrolytes, aquaporin 2 (AQP2) and prostaglandin E2 (PGE2). We found a marked night-time decrease in diuresis (from 1.69±0.08 to 0.86±0.06ml/kg/h,p<0.001) caused by a significant night-time increase in solute-free water reabsorption(TcH2O)(Day-Night ratio 0.64±0.07,p<0.001) concurrent with a significant decrease in osmotic excretion (Day-Night ratio 1.23±0.06,p<0.001). Plasma AVP expressed a circadian rhythm (p<0.01) with a night-time increase and peak levels at midnight (0.49±0.05 pg/ml). The circadian plasma AVP rhythm was not influenced by gender (p=0.56) or puberty stage (p=0.73). There was significantly higher night-time TcH2O in pre-puberty children. This concurred with increased night-time urinary AQP2 excretion in pre-puberty children. Urinary PGE2 exhibited circadian rhythm independent of sex or puberty stage. The levels of serum 17-β-estradiol and testosterone were as expected for sex and pubertal stage and no effect on AVP-AQP2- TcH2O axis was observed. This study finds a circadian rhythm of plasma AVP independent of sex and puberty stage, though night-time solute-free water reabsorption was higher and AQP2 excretion more pronounced in pre-puberty children suggesting higher pre-puberty renal AVP sensitivity.