Antidiuretic hormone & bull; hello healthy

Definition

What is an antidiuretic hormone?

Antidiuretic hormone or antidiuretic hormone (ADH) is used to diagnose and determine the cause of deficiency or excess of antidiuretic hormone. However, this test is not a general test. Doctors usually diagnose the patient's condition based on clinical symptoms and other tests such as blood osmolality test, urine osmosis and electrolyte tests.

ADH or vasopressin is produced in the hypothalamus and stored in the posterior pituitary lobe. ADH regulates the water content that is absorbed by the liver. Osmotic pressure at high serum or decreased intravascular blood volume will stimulate ADH production. Stress, surgery, or mental stress can also stimulate ADH. The more ADH that is produced, the more water is absorbed into the kidneys. Water will be absorbed a lot in the blood and thicken the urine. When ADH decreases, the body releases water, causing the concentration of blood and urine to dilute.

Diabetes insipidus occurs when the body doesn't produce enough ADH or the kidneys are unable to adapt to the irritation of ADH. Insufficient levels of ADH secretion are due to abnormal central nervous system (neurogenic diabetes insipidus), trauma, tumors, encephalitis (swelling of the hypothalamus), or removal of the pituitary gland. Diabetes insipidus patients release high water levels with each urination. This causes the blood to thicken, making the patient feel thirsty easily.

Primary kidney disease can cause the kidneys to become less sensitive to stimuli from ADH (nephrogenic diabetes insipidus). To differentiate between neurogenic diabetes insipidus and nephrogenic diabetes insipidus, a doctor may order an ADH stimulation test. In this test, the patient is prohibited from drinking water and urinary osmolality will be measured before and after the injection of vasopressin. If neurogenic diabetes insipidus is found, urinary osmolality with constant water content will decrease, and urinary osmolality will increase after being given vasopressin. In the case of nephrogenic diabetes insipidus, urinary osmolality will not increase even if you reduce the water content and use vasopressin. Diagnosis results may include a serum ADH test. In the case of neuropathic diabetes insipidus, the ADH level is low, while in the case of nephrogenic diabetes insipidus, the ADH level is high.

High serum ADH levels are often associated with Syndrome of Inappropriate ADH (SIADH). Due to the excess secretion of ADH, too much water is absorbed in the kidneys compared to normal levels. This results in the blood becoming watery and the urine thickening. The concentration of essential ions in the blood decreases, resulting in serious disorders of the nerves, heart and metabolism. Syndrome of Inappropriate ADH is also often associated with lung disease (tuberculosis, pneumonia caused by infection), excess stress (surgery or trauma), brain tumors or infections. Secretion of ADH in tumors can also cause a Syndrome of Inappropriate ADH. Tumors can cause syndromes such as epithelial tumors, lung, lymph node, urinary and intestinal tumors. Hypothyroidism and Addison's patients may also develop Syndrome of Inappropriate ADH.

Doctors use this test to differentiate Syndrome of Inappropriate ADH from hyponatremic disease or edema. This test is also frequently used to measure urine osmolality and osmosis. Patients with Syndrome of Inappropriate ADH are unable to produce or produce little water intake. In addition, the urinary osmolality is usually not lower than 100, and the urinary or blood infiltration rate is more than 100. Patients with other causes of hyponatremia, edema and chronic kidney disease may account for 80% of their water intake and urinary osmolality will be insufficient.

When should I take antidiuretic hormone?

Your doctor may recommend an ADH test or other test as part of a cessation test or ADH inhibition if your doctor suspects an obstacle to ADH production or secretion.

In addition, this test may also be recommended if you have unexplained low sodium levels in your blood, or if you have symptoms related to Syndrome of Inappropriate ADH (SIADH).

If SIADH progresses unnoticed, there will be no symptoms, but if the condition is acute, several symptoms may occur:

headache
nauseous vomit
dizzy
coma or convulsions

The ADH test is done to evaluate excess ADH caused by other medical causes, such as:

leukemia
lymphoma
lung, pancreatic, bladder and brain cancer
diseases that increase ADH production
Guillain Barre Syndrome
sclerosis
epilepsy
acute gusts porphyria (an inherited disorder that affects the production of heme, an important component of blood)
cystic fibrosis
emphysema
tuberculosis

Dehydration, brain injury, and surgery can increase ADH concentrations.

The ADH test can be done when the patient feels very thirsty and has frequent urination, to make it easier for doctors to determine diabetes insipidus.

Patients with central diabetes insipidus (diabetes insipidus caused by damage to the hypothalamus, pituitary) often feel tired due to disturbed sleep cycles, because the patient often goes to the bathroom at night. The urine is usually clear, not cloudy, and has a lower penetration rate than usual.

Precautions & warnings

What should I know before taking antidiuretic hormone?

You need to be aware of the things that can affect the test results:

if you are dehydrated, hypovolemia or excess stress, your ADH levels may rise
if you drink too much water, which can reduce serum osmolality or increase blood volume, ADH levels may decrease
if a glass syringe or tube is used, it can degrade ADH quality
The following drugs increase the concentration of ADH and can cause SIADH: acetaminophen (Panadol), barbiturates, carbamazepine (anesthetics), anticholinergic agents (cholinergic treatment), cyclophosphamide (Immunosuppressive treatment cytotoxic group), some diuretics (thiazides), estrogen, opium, nicotine , oral hypoglycemic drugs (lasulfonylureas), and three ring antidepressants or SSRIs antidepressants
drugs that can potentially reduce ADH levels: alcohol, beta-adrenergic, anti-morphine and phenytoin

It is important that you understand the warnings above before running this test. If you have any questions, consult your doctor for further information and instructions.

Process

What should I do before taking antidiuretic hormone?

pay attention to the doctor's instructions and explanations for the test process
Make sure you drink enough water and fast for 12 hours
your doctor will assess your stress level
before the test, your doctor may advise you to avoid certain drugs, follow the doctor's instructions

How is the antidiuretic hormone process?

The doctor will take a blood sample while you are sitting or lying down, and store it in a plastic tube with a red lid.

The ADH blocking test is needed to measure the original serum to estimate the water content the patient is consuming. The urine is then taken at a certain proportion and osmosis. Blood is drawn for washing.

What should I do after taking antidiuretic hormone?

After the blood draw, wrap it in a bandage and lightly press on the blood vessel to stop the bleeding
the doctor may freeze the serum and send it to a laboratory for further investigation

If you have any questions about this test process, please consult with your doctor to understand more.

Explanation of the Test Results

What do my test results mean?

Test results may vary depending on the laboratory. Consult your doctor if you have questions about test results.

Normal result:

HCG: 1-5 pg / mL or 1-5 ng / L (SI unit).
ADH blocking test (drinking test).
- - - 65% water is excreted for 4 hours.
    - 80% water is excreted for 5 hours.
    - Urine permeability (at second hour) ≤100 mmol / kg.
    - Urinary / serum osmolality rate> 100.
    - Urine gravity <1,003