Role of copeptin as biomarker of volume overload in children with end-stage renal disease

Abstract

Background Children who undergo dialysis may develop hypertension and cardiovascular morbidity as a result of fluid overload. The intravascular parameter is clinically relevant in children because it directly influences systemic blood pressure, cardiac output, and cardiovascular squeals. Optimum fluid management is still a chronic clinical challenge, despite recent advances in the care of children with end-stage renal disease (ESRD). The paraventricular and supraoptic nuclei of the hypothalamus emit arginine vasopressin (AVP), a nonapeptide. It is secreted into the bloodstream by the pituitary gland in response to both osmotic and nonosmotic stimuli. Copeptin and AVP are released at equimolar concentrations. The aim of the study is to determine if copeptin, a surrogate marker of AVP, may be used to predict unfavorable outcomes, including chronic volume overload and its impact on hypertension and cardiovascular diseases in children undergoing dialysis. Results A cross-sectional study including 65 children: The mean age of the investigated patients was 10.79 ± 2.857 years, with 53% being male. The patient group had significantly greater mean blood levels of AVP and copeptin compared to the control group (P value = 0.0001). 45% of patients experienced cardiac issues, specifically left ventricular hypertrophy. Hypertensive patients accounted for 57%. The mean blood levels of AVP and copeptin were considerably greater in individuals with cardiac problems and hypertension. Conclusions Hemodynamics have a significant influence on cardiac function and hypertension in children receiving hemodialysis. Copeptin is a more appropriate biomarker for evaluating the effects of AVP on hypertension and cardiac problems in children with ESRD.