Vasopressin in chronic kidney disease: an elephant in the room?

Perico et al. report that a dual arginine vasopressin (AVP) V(2) and V(1a) receptor antagonist lowers blood pressure, proteinuria, and glomerulosclerosis in 5/6 nephrectomized rats, pointing to its potential value in the treatment of chronic kidney disease (CKD). AVP likely contributes to CKD progression by its effects on renal hemodynamics, blood pressure, and mesangial and/or epithelial cells, but the relative contributions of V(2) and V(1a) receptors and potential usefulness of V(2) and V(1a) receptor antagonists remain ill defined.