Calcium-Stimulated Vasopressin Secretion in Uremic Patients: An Effect Mediated via Parathyroid Hormone?*

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Abstract
The effect of whole blood ionized Ca levels on vasopressin (AVP) secretion was studied in 12 uremic hemodialysis patients (6 nephrectomized and 6 nonnephrectomized), 6 healthy subjects, and a sprue patient, first while she was hypocalcemic and again after her blood Ca had normalized. Changes in whole blood ionized Ca were induced by Ca infusion (3.15 mg Ca/kg body wt per h). In uremic patients, plasma AVP increased during infusion, and the changes in AVP were correlated to the changes in whole blood ionized Ca. In normals, no changes in AVP were found. In the sprue patient, an increase in plasma AVP correlated to whole blood ionized Ca was found in the hypocalcemic state, but this could not be demonstrated after treatment. Parathyroid hormone facilitated Ca entry into cells, and the pathophysiological effect of Ca on AVP secretion in uremic patients could be caused by the elevated parathyroid hormone level found in these patients.

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