The Physiological Regulation of Thirst and Fluid Intake

McKinley, Michael J.; Johnson, Alan Kim

doi:10.1152/nips.01470.2003

Cited by 241 publications

(306 citation statements)

References 17 publications

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“…Although patients were not questioned regarding thirst, the mechanisms of the polydipsia of the higher levels of paralysis can be considered from the list of reported causes of thirstdepletion of intracellular volume or of extracellular volume, central nervous system lesions, and hormonal effects. 20 Taking the first consideration, total water per body weight in the spinal cord injured subject is reportedly comparable to controls, but intracellular volume is diminished and extracellular volume is expanded (although intravascular volume is constricted). 17,21,22 Furthermore, the intracellular volume is more constricted in the tetraplegic than in the paraplegic subject, thus coinciding with the polydipsia of higher levels of paralysis in the current survey.…”

Section: Discussionmentioning

confidence: 97%

Salt wasting, hypotension, polydipsia, and hyponatremia and the level of spinal cord injury

Frisbie

2006

Spinal Cord

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Study Design: Case control. Objective: To test the reported correlation of hypotension, polydipsia, and hyponatremia with higher levels of spinal cord injury (SCI). Setting: A Veterans Administration Hospital, USA. Methods: The records of men who were paralyzed owing to trauma at any spinal cord level with motor complete lesions (ASIA A or B) and who received an annual physical and laboratory examination were reviewed for age, duration of paralysis, level of paralysis, blood pressure (BP), serum sodium, and 24 h urinary volume, creatinine, and sodium. Creatinine clearance and fractional excretion of sodium (FcNa) were calculated. Spearman rank-order correlations (r s ) were carried out. Results: Patients were aged 25 to 88 years, median 56 years, paralyzed 2-61 years, median 26 years, with levels of paralysis ranging from C2 to L4, median T4, n ¼ 111. From lower to higher levels of paralysis FcNa increased (0.4-7.3%), mean BP diminished (132-66 mmHg), urine volume increased (600-5400 ml), and serum sodium was reduced (148-129 mEq/l) -r s ¼ 0.29, 0.49, À0.22, and 0.23, respectively. Increasing 24 h urinary volumes correlated with lower serum sodium concentrations but higher creatinine clearance, r s ¼ À0.28, 0.24. Increasing 24 h urinary sodium improved creatinine clearance, r s ¼ 0.37. P-values ranged from o0.05 to o0.001. Conclusion: Higher levels of SCI correlate with reduced sodium conservation, hypotension, polydipsia, and hyponatremia. Greater water intake raises creatinine clearance but lowers serum sodium. Greater salt intake increases creatinine clearance.

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Section: Discussionmentioning

confidence: 97%

Salt wasting, hypotension, polydipsia, and hyponatremia and the level of spinal cord injury

Frisbie

2006

Spinal Cord

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“…Extracellular fluid osmolality is monitored by osmosensitive neurons located in two circumventricular organs in the preoptic/ anterior hypothalamus, the subfornical organ (SFO) and organum vasculosum of the lamina terminalis (OVLT; [38]) as well as peripheral osmoreceptors [83] and the VP neurons themselves [37]. As shown in Fig 2, osmoresponsive neurons in both SFO and OVLT express ERα [76] (See Table 2), and the ERα expressing neurons in OVLT, SFO, and median preoptic nucleus project to SON [93].…”

Section: Osmoreceptive Afferentsmentioning

confidence: 99%

“…The ERα expressing neurons in these regions express AT1 angiotensin receptors [56], and the neurons in these regions that project to SON and PVN are responsive to relaxin [85]. Both of these hormones stimulate VP secretion, and their potent dipsogenic actions are mediated by the SFO [38]. Thus, activation of ERα in SFO, OVLT, and MnPO has the potential for modulating both fluid intake and output (see [74] for further discussion of estrogen effects on thirst).…”

Section: Osmoreceptive Afferentsmentioning

confidence: 99%

“…Since circulating steroids were reduced by dehydration [77,78], the increase in ERα expression in SFO may be a mechanism for maintaining the influence of circulating gonadal steroids during circumstances of reduced ligand availability. Thus this may be important for maintaining fluid homeostasis by regulating both water excretion via VP secretion and water intake by regulating thirst [38]. The impact of estrogen on thirst has been considered in more detail in a recent review [74].…”

Section: Impact Of Fluid Balance On Er Expression Erα Expression In Omentioning

confidence: 99%

“…Scale bars, 50μm. Modified from [38,76]. Effect of 3-β-diol, an androgenic metabolite of testosterone that acts as an ERβ agonist, on NMDA-stimulated VP release from explants of the hypothalamo-neurohypophyseal system (HNS).…”

Section: Conclusion and Future Researchmentioning

confidence: 99%

See 2 more Smart Citations

Estrogen receptors: Their roles in regulation of vasopressin release for maintenance of fluid and electrolyte homeostasis

Sladek

Somponpun

2008

Frontiers in Neuroendocrinology

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Long standing interest in the impact of gonadal steroid hormones on fluid and electrolyte balance has led to a body of literature filled with conflicting reports about gender differences, the effects of gonadectomy, hormone replacement, and reproductive cycles on plasma vasopressin (VP), VP secretion, and VP gene expression. This reflects the complexity of gonadal steroid hormone actions in the body resulting from multiple sites of action that impact fluid and electrolyte balance (e.g. VP target organs, afferent pathways regulating the VP neurons, and the VP secreting neurons themselves). It also reflects involvement of multiple types of estrogen receptors (ER) in these diverse sites including ERs that act as transcription factors regulating gene expression (i.e. the classic ERα as well as the more recently discovered ERβ) and potentially G-protein coupled, membrane localized ERs that mediate rapid non-genomic actions of estrogen. Furthermore, altered expression of these receptors in physiologically diverse conditions of fluid and electrolyte balance contributes to the difficulty of using simplistic approaches such as gender comparisons, gonadectomy, and hormone replacement to assess the role of gonadal steroids in regulation of VP secretion for maintenance of fluid and electrolyte homeostasis. This review catalogs these inconsistencies and provides a frame work for understanding them by describing: 1) the effect of gonadal steroids on target organ responsiveness to VP; 2) the expression of multiple types of estrogen receptors in the VP neurons and in brain regions monitoring feedback signals from the periphery; and 3) the impact of dehydration and hyponatremia on expression of these receptors.

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The Osmotic Control of Vasopressin‐Releasing Neurons

Choe

Bourque

2014

Neurophysiology of Neuroendocrine Neurons

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The Physiological Regulation of Thirst and Fluid Intake

Cited by 241 publications

References 17 publications

Salt wasting, hypotension, polydipsia, and hyponatremia and the level of spinal cord injury

Salt wasting, hypotension, polydipsia, and hyponatremia and the level of spinal cord injury

Estrogen receptors: Their roles in regulation of vasopressin release for maintenance of fluid and electrolyte homeostasis

The Osmotic Control of Vasopressin‐Releasing Neurons

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