Vasopressin - Effects, High and Low Levels, Diagnosis, and Treatment

Introduction:

The human body is made up of around 60 percent water. Though there is a wide variation in the amount of water consumed every day, the body maintains equilibrium in the water levels, which is possible due to the effects of hormones on the kidneys and the blood vessels. The essential hormone that plays a role in regulating the amount of water in the body is vasopressin or antidiuretic hormone (ADH). Vasopressin acts on the kidneys and helps to reabsorb water, thereby increasing the blood volume and urine concentration and decreasing water loss.

What Are the Other Names of Vasopressin?

The other names of vasopressin include:

• Antidiuretic hormone (ADH).

• Arginine vasopressin (AVP).

• Argipressin.

Which Actions Are Promoted by the Vasopressin on the Body?

The hypothalamus, an area at the base of the brain, is connected to the pituitary gland through nerves. The hypothalamus produces hormones that are stored and released by the pituitary. Vasopressin, or arginine vasopressin (AVP), is one such hormone. The body has sensors called baroreceptors that can detect a decrease in the volume of water. These sensors signal the pituitary gland to release vasopressin, which directs the kidneys to reabsorb water from the urine, which helps retain water in the body and helps increase blood volume, blood pressure, and urine concentration. Vasopressin has an antidiuretic action on the kidney’s collecting ducts.

What Are the Effects of Vasopressin Release?

As vasopressin or arginine vasopressin (AVP) helps the kidneys conserve water, the following effects occur in the body that includes:

• Dilution of blood.

• Increase in the blood volume.

• Increase in blood pressure.

• Decrease in blood osmolarity.

• When the amount of ADH vasopressin, or arginine released does not suffice, a feeling of thirst is stimulated, making the affected person drink more water, compensating for the low blood volume.

What Happens When the Body Produces Too Little Vasopressin?

The pituitary gland may sometimes release less vasopressin or arginine vasopressin (AVP), or the kidneys may be less sensitive to vasopressin, leading to significant body water loss.

The signs and symptoms of low vasopressin are:

• Frequent urination.

• Increased thirst.

• Dehydration.

• High blood sodium levels.

What Happens When the Body Produces Too Much Vasopressin?

Sometimes, the body produces too much vasopressin or arginine vasopressin (AVP), which leads to water retention.

The signs and symptoms of high vasopressin are:

• Nausea.

• Headaches.

• Fatigue.

• Disorientation.

• Low blood sodium levels.

What Is the Medical Use of the Vasopressin Drug?

Medical Use:

• The Vasopressin drug treats anti-diuretic hormone deficiency, such as diabetes insipidus. It is a condition in which the body does not produce enough arginine vasopressin (AVP) or vasopressin, leading to excessive water loss. As a result, the affected person has increased thirst and frequent urination. There are two types of diabetes insipidus.

  • Central Diabetes Insipidus: Central diabetes insipidus occurs when the pituitary gland does not release sufficient vasopressin due to trauma to the head, brain tumors, infection, or inherited genetic disorder. Symptoms include the urge to urinate frequently (polyuria), which leads to excessive thirst (polydipsia). The urine is colorless, odorless, and clear, with a low concentration of electrolytes and proteins. The affected people are exhausted all the time as their sleep cycles get affected due to frequent urination. The condition, if left untreated, can lead to severe dehydration.

  • Nephrogenic Diabetes Insipidus: Nephrogenic diabetes insipidus is a condition that occurs due to the inability of the kidneys to respond to arginine vasopressin. It occurs as an inherited condition or is secondary to kidney disorders.

• The vasopressin drug is also used to treat other medical conditions, such as gastrointestinal bleeding (bleeding in the digestive tract), vasodilatory shock (widespread blood vessel dilation, causing decreased organ perfusion), ventricular fibrillation (life-threatening heart rhythm where ventricles quiver instead of pumping blood effectively), and ventricular tachycardia (rapid heart rhythm from ventricles, potentially causing palpitations and chest discomfort).

• Also, long-acting analogs of Vasopressin, such as Desmopressin and Terilipressin, are used to control bleeding (in hemophilia A) and as a vasoconstrictor.

• Vasopressin infusion drugs are used as a substitute for catecholamines (such as Dopamine) and as a second-line treatment for septic shock to increase blood pressure.

Side Effects of Vasopressin Drug:

• Chest pain.

• Dizziness.

• Angina.

• Vomiting.

• Fever.

• Heartburn.

• Nausea.

• Trembling.

• Diarrhea.

• Sweating.

• Water intoxication.

• Flatulence.

• Paleness.

Contraindications:

• Chronic kidney failure.

• Increased blood urea nitrogen (BUN).

• Hypersensitivity to pork and beef.

• Heart failure.

• Asthma.

• Drug sensitivity.

• Migraine headaches.

• Perioperative polyuria.

What Is the Syndrome of Inappropriate Antidiuretic Hormone (SIADH)?

Excess production of vasopressin, or ADH or arginine vasopressin (AVP) from the hypothalamus and other parts of the body causes a syndrome of inappropriate antidiuretic hormone (SIADH). As a result, water retention occurs in the body, which leads to a fall in electrolyte levels, especially sodium, causing mild to severe symptoms. Mild symptoms include cramps, nausea, and vomiting. More severe symptoms include convulsions, confusion, and coma. Treatment includes limiting fluid intake, medications that increase urine output, and those that inhibit vasopressin's actions.

What Are the Tests Done to Determine the Vasopressin Levels?

Doctors diagnose an imbalance in the arginine vasopressin (AVP) or vasopressin levels based on the medical history, physical examination, urine analysis, and lab tests to detect the levels of electrolytes. Apart from the above, the doctor may recommend special tests, namely a water deprivation test and a water loading test. Based on all the above tests, the doctor may diagnose any underlying health conditions causing symptoms of too low or too high vasopressin levels and treat them accordingly.

• Water Deprivation Test: The health care team advises stopping the intake of fluids several hours before the test. The body releases arginine vasopressin to prevent dehydration due to restricted fluid intake, which helps the kidneys avoid water loss and produce more concentrated urine. The doctor measures the urine output, levels of vasopressin, blood and urine concentrations, and the patient's weight during the test. The test helps assess whether the pituitary releases sufficient amounts of vasopressin and if the kidneys can respond to vasopressin.

• Water Loading Test: The patient needs to fast for a specific time as suggested by the doctor. In addition, the patient is advised to drink a particular quantity of water at regular intervals. The urine output and blood concentration are monitored continuously to assess for an imbalance of arginine vasopressin (AVP) or vasopressin.

What Are the Measures to Treat Vasopressin Symptoms?

The following are the key measures that help to treat vasopressin, ADH, or arginine vasopressin (AVP) symptoms:

• Drinking plenty of fluids.

• Maintaining a healthy diet.

• The doctor prescribes a synthetic ADH pill to treat low vasopressin levels.

• Alternate options for medications that are affecting vasopressin levels.

• Quitting smoking and drinking.

What Are the Uses of Vasopressin Injection?

Vasopressin, or ADH, or arginine vasopressin (AVP), is available in injection form and is used for the management of the following conditions:

• Treatment of diabetes insipidus causes frequent urination, excessive thirst, and water loss.

• Prevention and treatment of stomach distension that occurs post-surgery.

• Restoring blood pressure in patients with severe blood loss.

How Is Vasopressin Used During Surgery and Anesthesia?

During surgery and anesthesia, vasopressin, ADH, or arginine vasopressin (AVP) concentration is used to evaluate surgical stress for the surgical procedure. During abdominal surgeries, especially those involving traction viscera, abdominal insufflation, and gut manipulation, noxious stimuli elevate plasma Vasopressin concentration during laparoscopic surgeries with carbon dioxide.

Conclusion:

A balance in the water levels has to be maintained for the proper functioning of the body. Water is the primary source for transporting minerals, proteins, and glucose to different body parts. Therefore, any changes in the body's functioning need to be addressed and diagnosed early. Treatment options to correct the levels of vasopressin help prevent severe complications like dehydration.