Hormonal regulation of fluid homeostasis in chronic obstructive pulmonary disease patients

ABSTRACT

This study was carried out on 20 chronic obstructive pulmonary disease [COPD] patients and 10 normal control subjects of the same age group to show the interrelationship of hormones regulating fluids in COPD patients. There was no significant statistical difference in the serum sodium concentration or aldosterone or plasma arginine vasopressin [AVP] levels. On the other hand, plasma atrial natriuretic factor [ANF] was significantly increased in COPD group. Also, in COPD patients, the FEV1, FVC, MEFR, MMFR and MVV were significantly decreased from their predicated values while blood value was significantly increased of these COPD patients. Thirteen were nonedematous while seven were edematous, i.e. showing clinically; evident edema or having a past history of edema, between these both groups, blood volume, PCO2, serum aldosterone and plasma AVP were significantly different showing increase in those indices in the edematous group, while the right atrial pressure, mean pulmonary artery pressure, serum sodium, PO2 and plasma ANF were not significantly different. The present study showed that hypercapnia plays a cardinal role in the pathogenesis of hypervolemia and development of edema in COPD patients. This seems to be mediated principally through increase in hormonal levels of aldosterone and AVP