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PubMed1983

Primary polydipsia. Syndrome of inappropriate thirst.

A patient with lifelong severe polyuria and polydipsia had normal serum antidiuretic hormone (ADH) levels and responded to water deprivation with a prompt increase in urine osmolality and maintenance of normal plasma osmolality (less than 290 mOsm/kg), despite extreme thirst. When treated with desmopressin acetate and allowed free access to water, she was able to reduce plasma osmolality below 270 mOsm/kg, and her compelling thirst disappeared. The disorder is interpreted to be the result of excessive fluid intake in response to a thirst stimulus that was not inhibited by normal plasma osmolality. This study indicates that osmoreceptor control of ADH secretion is normal. Continued administration of vasopressin has relieved the symptoms and has not resulted in water intoxication.

Adult↗
PubMed1990

[Regulation of thirst in end-stage kidney insufficiency].

About 30% of hemodialyzed patients are suffering from chronic fluid overload despite advice to restrict the oral fluid intake. To investigate the cause of the abnormal drinking behaviour a clinical study was performed in 51 non-diabetic patients with endstage renal disease exhibiting lower interdialysis weight gain (less than 3 kg, n = 17) and increased interdialysis weight gain (greater than 3 kg, n = 34). Blood pressure, body weight self-estimated thirst intensity before and after hemodialysis were analyzed. Biochemical and behavioral variables were measured including hormonal factors of water and sodium metabolism. Significant differences of dry weight, creatinine, urea nitrogen and thirst intensity were found between the two groups. Catecholamines, renin, angiotensin II, aldosterone, vasopressin and atrial natriuretic peptide exhibited a similar pattern in both groups. Atrial natriuretic peptide decreased during hemodialysis in both groups, angiotensin II, however, and norepinephrine showed an exaggerated response to ultrafiltration rate in polydipsic patients. These results suggest that changes in serum osmolality during hemodialysis did not contribute to thirst and drinking behaviour. It seems that postdialytic hypovolaemia together with higher plasma-angiotensin II-levels is responsible for increased oral intake of fluid and excessive weight gain.

Angiotensin II↗
PubMed1994

Thirst induced by increasing brain sodium concentration is mediated by brain angiotensin.

Thirst, the longing or compelling desire to drink, arises physiologically by two main mechanisms-extracellular and cellular dehydration. The hormone angiotensin II has been implicated in the former but not in the latter brain mechanism. To test this apparent difference, experiments in 5 mammalian species examined the effect of intracerebroventricular infusion of losartan, an angiotensin II type I receptor antagonist, on the third induced by intracerebroventricular infusion of an artificial cerebrospinal fluid made hypertonic by the inclusion of 500 mM NaCl. The losartan infusion reduced the water intake due to increased brain sodium concentration in all 5 species, cattle, sheep, rabbits, rats and mice. Thus, the thirst evoked by cellular dehydration, as well as the thirst evoked by extracellular dehydration, may be mediated by angiotensin II.

Angiotensin II↗
PubMed1979

Effect of an angiotensin converting enzyme inhibitor (SQ 14,225) on beta-adrenergic and angiotensin-induced thirsts.

The effect of acute administration of SQ 14,225, a new angiotensin converting enzyme inhibitor, on the drinking response of female rats administered either isoprenaline, angiotensin I, or angiotensin II was studied during 2 h after treatment. Administration of isoprenaline (25 micrograms/kg body wt) was accompanied by a significant increase in water intake when compared with saline-treated controls. Acute administration of a constant dose of isoprenaline (25 micrograms/kg body wt) and increasing doses of SQ 14,225 (5--50 mg/kg) was accompanied by a dose-related, linear decrease in water intake. Acute administration of either angiotensin I or angiotensin II (200 micrograms/kg body wt) was accompanied by a significant increase in water intake. The dipsogenic response to angiotensin II was not affected by acute administration of 35 mg SQ 14,225/kg body wt. However, at the same dose of SQ 14,225, angiotensin I-induced thirst was attenuated. Since isoprenaline-induced and angiotensin I-induced, but not angiotensin II-induced, thirsts are blocked by SQ 14,225, the results suggest that isoprenaline-induced thirst is mediated by way of the renin--angiotensin system.

Angiotensin I↗
PubMed1989

Stimuli of thirst in donkeys (Equus asinus).

A study of the stimuli of thirst was conducted on six feral donkeys. Donkeys were found to be stimulated to drink by overnight water deprivation, by the diuretic furosemide, and by hypertonic saline infusion, all in the absence of heat stress or work. Donkeys compensate accurately for the fluid deficit caused by overnight water deprivation. After 19 hr without water, they drank 8.8 +/- 2.4 (mean +/- SE) liters within 60 min. Their undeprived overnight intake was 8.4 +/- 1.5 liters. However, latency was longer and water intake was less than that of ponies with the same changes in blood parameters, suggesting that donkeys have a higher thirst threshold than ponies. Further, plasma volume fell less in donkeys, but osmotic changes were similar to those reported in ponies exposed to the same deprivation. Donkeys infused with 250 ml of 15% NaCl drank 0.7 +/- 0.6 liters of water within 45 min, and osmolality increased from 287 to 297 mosmol/kg water; they drank no water in the same time period when infused with 250 ml 0.9% NaCl (p less than 0.05). Donkeys injected IV with 2 mg/kg furosemide drank 3.8 +/- 1.1 liters within 3 hr. Plasma protein increased from 6.9 to 7.8 g/dl. When injected with 0.9% NaCl they drank 1.0 +/- 0.5 liters (p less than 0.05). In sum, the positive thirst responses of these donkeys to cellular and extracellular dehydration were similar to those earlier demonstrated in ponies, but the results suggest a less sensitive response, albeit combined with a better internal defense of blood volume.

Animals↗
PubMed1992

Intraperitoneal administration of recombinant human interleukin-1 beta inhibits osmotic thirst in the rat.

Decrease in water intake after intraperitoneal injection of interleukin-1 beta (IL-1 beta) was studied in the rat. Administration of IL-1 beta at a dose of 20 micrograms/kg attenuated osmotic thirst induced by intraperitoneal injection of hypertonic saline, but did not affect hypovolemic thirst induced by subcutaneous injection of either polyethylene glycol or angiotensin II. Interleukin-1 beta also decreased spontaneous intake of water but not that of 1.8% saline. The results suggest that the decrease in water intake by IL-1 beta is caused, at least in part, by suppression of osmotic thirst but not by general suppression of behavior. The effects of IL-1 beta were not secondary responses accompanied by feeding behavior, since food supply was removed during the experiments. Pretreatment with indomethacin blocked the decrease in water intake by IL-1 beta, suggesting the involvement of production of prostaglandins.

Angiotensin II↗
PubMed1996

The role of angiotensin II in ingestive behaviour: a brief review of angiotensin II, thirst and Na appetite.

From the outset, the study of angiotensin II (Ang II) in body fluid homeostasis has been both complicated and intriguing. Since the publication of an early report of the dipsogenic action of this peptide, the pursuit of the role of Ang II in thirst and Na appetite has continued for the last 25 years. This pursuit captured the attention of all workers interested in the behavioural/physiological regulation of body fluid balance, with major contributions being made by James T. Fitzsimons and his colleagues. In spite of its powerful dipsogenic actions, delineation of its precise role in physiological thirst has been elusive and difficult to demonstrate. The influence of Ang II on Na intake took longer to show convincingly. However, in contrast to thirst, the role of Ang II in physiological Na appetite has been demonstrated clearly. The technological advances made during the recent years have greatly increased our ability to delineate the neurobiological context of Ang II-mediated responses. Thus, the future is promising in regard to illuminating the subtleties of the role of Ang II in body fluid balance.

Angiotensin II↗
PubMed1983

Experiments on the neuropsychology of thirst.

We report the results of a series of experiments whose main objectives are: (a) the identification of neural receptors for thirst; and (b) other neural structures of critical importance for thirst and drinking behavior. We have used results from hypertonic challenges during acute unit and multiple-unit recording experiments to identify responsive brain areas for behavioral study in chronic experiments. Results include the following. Single cells in the lateral preoptic area (LPOA) responded to injections of hypertonic saline into the carotid artery in a dose-related manner. Multiple unit activity (MUA) reactions were invariably facilitatory to challenge, and were much greater in the LPOA than in the medial preoptic area (MPOA). In unit and MUA recording we found extremely osmosensitive sites in the dorsal midbrain. Comparing the effects of NaCl vs sucrose as challenges via the intracarotid artery we found that LPOA MUA responses to sucrose were at least as strong and latencies as short as those to NaCl. These results support osmoreceptor theory, as revised by Epstein and his co-workers, and they are opposed to Andersson's sodium receptor theory. Hypertonic NaCl and sucrose solutions (but not artificial CSF controls) injected into the lateral ventricle were effective in producing strong MUA reactions, which typically were inhibition followed by facilitation. These and other findings support the following conclusions. (a) The LPOA appears to be a vital part of the neural mechanism for thirst and it is a probable site of osmoreceptors. (b) In addition, the LPOA seems to be a receiving area connected with putative periventricular neural receptors. (c) Intraventricular (i.v.t.) angiotensin II seems to be a much stronger dipsogen than hypertonic NaCl i.v.t., which in higher concentrations elicited stereotyped running.

Angiotensin II↗
PubMed2006

Control of thirst and salt appetite in rats: early inhibition of water and NaCl ingestion.

Most previous studies on the controls of thirst and salt appetite in rats have focused on systemic factors. Our recent experiments suggest that presystemic factors also are likely to play an important role. For example, dehydrated rats were found to consume similar volumes in an initial drinking bout when given access either to water or 0.05, 0.10, 0.15, or 0.20 M NaCl solution. Thus, cessation of the bouts evidently was not related to the concentration of fluid consumed but to its volume. It occurred despite the continued presence of known systemic stimuli for thirst (i.e. either increased plasma osmolality or decreased plasma volume), and therefore it resulted from inhibition rather than satiation. This inhibition appeared to derive from signals related to the cumulative volume of ingested fluid in the stomach and small intestine. Similar findings were obtained in studies of NaCl solution intake by NaCl-deprived adrenalectomized rats. These and other observations suggest that gastrointestinal fill generates stimuli that inhibit drinking in rats regardless of whether thirst or salt appetite motivates fluid consumption and regardless of whether rats consume water or NaCl solution.

Animals↗
PubMed2004

Thirst changes in offspring of hyperreninemic rat dams.

The aim of this study was to investigate the changes in thirst dependence on the renin-angiotensin system (RAS), in offspring of hyperreninemic, hyperdipsic, and natriophilic rat dams. Female rats underwent a partial aortic ligature between the renal arteries (PAL) or were sham-operated (SHAM). At 6 days of age, offspring of PAL (O-PAL) and SHAM (O-SHAM) dams were injected with isoproterenol (subcutaneously, 500 microg/kg body weight) or vehicle. Pretreatment with captopril (intraperitoneally, 50 mg/kg) on isoproterenol-induced thirst was also studied. Plasma renin activity in dams and hematocrit and osmolality in pups were measured. O-PAL had a greater water intake than O-SHAM. However, they responded similarly to isoproterenol or isoproterenol with captopril pretreatment. Only minor differences in hematocrit and osmolality were found between O-SHAM and O-PAL rats after isoproterenol or vehicle treatment. Beta-adrenergic or angiotensinergic responsivity seems not to be altered in offspring of hyperrenimic, hyperdipsic, and natriophilic dams. Nevertheless, other thirst responses of offspring may be critically dependent upon uterine conditions.

Animals↗
PubMed2002

AT(1) receptor blockade with losartan during gestation in Wistar rats leads to an increase in thirst and sodium appetite in their adult female offspring.

We studied the effects of angiotensin II receptor blockade with losartan on thirst and sodium appetite in pregnant Wistar rats and on their adult female offspring. During maternal adaptation to pregnancy, average daily total water intake increased by 63% (P<0.01); NaCl intake by 214% (P<0.001). These changes were not blocked by daily s.c. injections of losartan (50 mg/kg bw i.p.) from gestation day (GD) 2 until GD 19 which implied that maternal AT(1) receptors were not involved in the up regulation of thirst and sodium appetite during pregnancy. Losartan blockade during gestation led to a significant and continued increase in thirst and sodium appetite in the adult female offspring. Daily water intakes were greater in the losartan (LO) group than in the vehicle-injected control group (CO), leading to a total water intake of 1114 +/- 80.6 ml/kg bw compared with 738 +/- 56.7 ml/kg bw (P<0.05) during the 8-day period of observation. Daily sodium intakes were usually 2-3 times greater in the LO group compared with the CO group, amounting to a final cumulative intake of 232 +/- 33 mmol/kg bw compared with 93.8 +/- 16.5 mmol/kg bw (P<0.05) in 8 days. These elevated sodium and water intakes were nearly counterbalanced by the increased renal excretion of water and sodium by fully functional kidneys that were not injured by the drug. Body weights were 10% lower in the LO group at the start but remained unchanged relative to the CO group during the entire 8-day period of observation. Plasma electrolytes, blood hematocrit and carotid MABP in the LO group did not differ from the CO group.

Aging↗
PubMed2000

Thirst.

The homeostasis of body fluid traditionally is viewed as involving the regulation of its osmolality and of blood volume. However, the control of thirst is more complex than can be described in a two-factor model, and consideration of plasma sodium concentration and of arterial blood pressure also must be included in the discussion. This review is organized around those four variables and focuses on the seven distinct signals that appear to influence water intake in rats. These signals include four that are excitatory for thirst: increased plasma osmolality detected by cerebral osmoreceptors, decreased blood volume presumably detected by cardiac stretch receptors, increased circulating levels of angiotensin II detected by angiotensin II receptors in the subfornical organ, and increased gastric sodium load apparently detected by putative sodium receptors in the abdominal viscera. There also appear to be three signals that inhibit thirst: decreased plasma osmolality detected by cerebral osmoreceptors, increased arterial blood pressure detected by arterial baroreceptors, and increased gastric water load apparently detected by putative sodium receptors in the abdominal viscera.

Animals↗
PubMed1985

Side-effects of lithium at lower therapeutic levels: the significance of thirst.

The prevalence of thirst, subjective polyuria and related side-effects was investigated in 87 patients attending a lithium clinic and in a group of 52 controls. Thirst was surprisingly common, occurring in 67% of patients, in spite of the fact that they had been maintained on relatively low levels of lithium, and was due principally to the lithium rather than to other psychotropic drugs. Urine flow and impaired renal water absorption correlated with the serum lithium level and the length of treatment in the patients, despite the fact that few were clinically polyuric. The pattern of the results confirms previous suggestions that lithium may stimulate the thirst mechanism directly as well as via an increased renal resistance to vasopressin. The possible implications in terms of clinical response are discussed.

Bipolar Disorder↗
PubMed2000

Vasopressin and thirst in patients with posterior pituitary ectopia and hypopituitarism.

OBJECTIVE: Partial diabetes insipidus has been documented in patients with congenital hypopituitarism and posterior pituitary ectopia, some cases being clinically silent except for enuresis. The objective of our study was to evaluate vasopressin (AVP) secretion and thirst appreciation in hypopituitary patients with posterior pituitary ectopia. PATIENTS: Twelve males and three females, aged between 13 and 38 years (median 19 years). Eleven had multiple pituitary deficiencies, adequately replaced at the time of the study, and four were only growth hormone deficient. None of the patients suffered from polyuria, polydipsia or nocturnal enuresis. We tested the patients with a 5% NaCl infusion. Five patients with abnormal vasopressin production were also tested with nitroprusside, which affects baroceptor vasopressin secretion. RESULTS: We found that only two out of 12 patients had normal AVP secretion. Thirst assessment showed severe hypodipsia in one patient, hyperdipsia in three out of 15 and more subtle abnormalities in two out of 15 patients. Concordance was found between osmotically and baroceptor-stimulated vasopressin. CONCLUSIONS: Patients with posterior pituitary ectopia showed a high prevalence of subclinical subnormal vasopressin response to the osmolar stimulus and moreover an impairment of thirst appreciation. Our data on nonosmotically stimulated AVP release suggest the existence of a damage in the hypothalamic vasopressin secreting centres.

Adolescent↗
PubMed1999

Correlation of regional cerebral blood flow and change of plasma sodium concentration during genesis and satiation of thirst.

Positron emission tomography studies were conducted during genesis of moderate thirst by rapid i.v. infusion of hypertonic saline (0.51 M) and after satiation of thirst by drinking water. The correlation of regional cerebral blood flow with the change in the plasma Na concentration showed a significant group of cerebral activations in the anterior cingulate region and also a site in the middle temporal gyrus and in the periaqueductal gray. Strongest deactivations occurred in the parahippocampal and frontal gyri. The data are consistent with an important role of the anterior cingulate in the genesis of thirst.

Adult↗
PubMed2000

Thirst and work capacity of older people in a hot environment.

In a hot environment, especially during exercise, the main role of thermoregulative mechanisms is to dissipate excessive heat from the body. The most effective way of heat dissipation is sweat production and its evaporation off skin surface. Intense sweating results in a considerable loss of water and electrolytes. There are some results that indicate lower thirst of older men than young ones in response to a hot environment and osmotic stimuli. Our studies conducted in men of different ages exposed to a hot environment indicated that there were no significant differences in rectal temperature (Tre) or heat storage (S) among groups at rest. Lower Tre and lower S in older men with higher physical capacity for their age than in young ones with average physical capacity was shown. However, in all the experiments significantly lower thirst in older men than in the young was indicated. Special attention should be paid to fluid replacement among workers in a hot environment because of lower thirst and lower hydration of older men. These individuals may be exposed to dehydration risk during prolonged exercise, despite the possibility to tolerate heat strain as well as young ones. Further studies are necessary because of some diversity in the meaning of the results.

Adult↗
PubMed1992

Age-related changes in natural spontaneous fluid ingestion and thirst in humans.

Elderly humans have impaired responses to dehydration and overhydration when tested under experimental conditions. This study investigated whether under ad libitum conditions age-related changes in fluid intake and thirst could be detected. Adult humans (n = 262) maintained 7-day diaries of everything they ingested, the timing and conditions present, and subjective thirst, anxiety, depression, and activity. No differences were found in overall fluid intakes of subjects from 20 to 80 years of age, including equivalent fluid intake responses to solid food ingestion, subjective thirst, social stimuli, and stomach factors. However, fluid ingested in bouts increased slightly over the day for younger groups, whereas it declined markedly for elderly groups, producing a blunted diurnal rhythm. Also, elderly subjects ingested more coffee and less soda and alcohol. The findings indicate that elderly individuals, under ad libitum conditions, are able to obtain normal levels of fluid by the coingestion of fluids with solids.

Adult↗
PubMed1988

Osmoregulation of vasopressin secretion and thirst in cyclical oedema.

Osmoregulation of vasopressin release and thirst was studied in the mid-follicular and mid-luteal phases of the menstrual cycle of five patients with cyclical oedema defined by peripheral oedema and weight gain (greater than 3.0 kg) manifest in two consecutive luteal phases. Results are compared to those already obtained in eight healthy women. In the patients, basal plasma osmolality in the mid-luteal phase was significantly lower than in the mid-follicular periods (patients, 283 +/- 1, 287 +/- 1 mOsmol/kg, respectively, mean +/- SEM, P less than 0.05; controls, 282 +/- 1, 286 +/- 1 mOsmol/kg, respectively, P less than 0.05). Plasma osmolality (pOsm) and plasma arginine vasopressin (pAVP) were measured during hypertonic (850 mmol/l) saline infusion in both phases of the cycle; linear regression analyses of these data gave the following mean regression equations, (i) mid-follicular, pAVP = 0.55 (pOsm - 285), r = 0.94 and (ii) mid-luteal, pAVP = 0.42 (pOsm - 281), r = 0.93. The abscissal intercept was significantly different (P less than 0.025). Osmotic threshold for severe thirst onset was lower in the mid-luteal phase compared to the mid-follicular value (296 +/- 1, 299 +/- 1 mOsmol/kg, respectively, P less than 0.01). Basal data and results of thirst onset and theoretical threshold for vasopressin release in response to osmotic stimulation obtained in the patients were similar to healthy control women. We conclude that osmoregulation in cyclical oedema is normal.

Adult↗