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Pediatr Clin North Am. 2011 Oct;58(5):1271-80, xi-xii. doi: 10.1016/j.pcl.2011.07.013.

Pediatric disorders of water balance.

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  • 1Department of Endocrinology, Children's Hospital and Research Center Oakland, 747 52nd Street, Oakland, CA 94609, USA.

Abstract

Fluid homeostasis requires adequate water intake, regulated by an intact thirst mechanism and appropriate free water excretion by the kidneys, mediated by appropriate secretion of arginine vasopressin (AVP, also known as antidiuretic hormone). AVP exerts its antidiuretic action by binding to the X chromosome-encoded V2 vasopressin receptor (V2R), a G protein coupled receptor on the basolateral membrane of renal collecting duct epithelial cells. After V2R activation, increased intracellular cyclic adenosine monophosphate mediates shuttling of the water channel aquaporin 2 to the apical membrane of collecting duct cells, resulting in increased water permeability and antidiuresis. Clinical disorders of water balance are common, and abnormalities in many steps involving AVP secretion and responsiveness have been described. This article focuses on the principal disorders of water balance, diabetes insipidus, and the syndrome of inappropriate antidiuretic hormone secretion.

PMID:
21981960
PMCID:
PMC4624211
DOI:
10.1016/j.pcl.2011.07.013
[PubMed - indexed for MEDLINE]
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