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Subject: Antidiuretic Hormone
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Antidiuretic hormone (ADH), also known as vasopressin or arginine vasopressin, is a hormone secreted by the posterior pituitary. It regulates the water permeability of renal collecting ducts and urine concentrating ability by increasing water reabsorption, which is mediated by transcellular water channels (aquaporins).
Normal range: <1.5 pg/mL (see Table 16.9 for effect of plasma osmolality on ADH levels).
Diagnosis and differential diagnosis of DI and psychogenic polyuria
Diagnosis of SIADH
Differential diagnosis of hyponatremias
Nephrogenic DI (partial or complete): high ADH and low osmolality
Primary psychogenic polydipsia
SIADH inappropriately increased for degree of plasma osmolality (i.e., normal ADH relative to osmolality)
Ectopic ADH syndrome
Certain drugs (e.g., chlorpropamide, phenothiazine, Tegretol)
Central DI (partial or complete): decreased for level of plasma osmolality
Higher secretion occurs at night; in erect posture; with pain, stress, or exercise; and with increased plasma osmolality.
Lower secretion occurs in recumbency, hypoosmolality, volume expansion, and hypertension.
Plasma sample should not be left at room temperature.