Antidiureti hormone

the Antidiureti hormone (ADH) is called also Adiuretin. A further name for the hormone is Vasopressin, since it works also strongly container-narrowing.


Bild:VasopressinSek.PNG


Table of contents

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production

ADH is produced in a central area (Nucleus supraopticus) hypothalamus (a part of the Zwischenhirns) of nerve cells.

The hormone is transported along the hypophysis handle axonal,in vesicles of the hypophysis behind rag stored and if necessary directly into the blood delivered. It is effective in extremely low concentration: the kidney addresses already on some billionths gram of the hormone.

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physiology

the Antidiureti hormone is in Thirst hormone. In the kidney it causes an increased back absorption of water from the primary urine of the collecting pipe, by more Aquaporine (AQP2) into the plasma membrane of the Tubuluszellen are built.

If one drinks more waters, than the body needs, then that reducesHypophysis behind rag the release of ADH and it comes to the increased elimination of water.

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normal values

12 hours before the blood acceptance must be kept an alcohol, a nicotine, Coffein Karenz and 48 hours before medicine Karenz. The regulation comes from at least 4.0mL, frozen EDTA plasma by means of RIA.

  • Blood: normally 2.9 ± 1.0 pg/ml for adults
    • other data: 2,0 - 8.0 pg/ml
  • Osmolalität: Indirect estimation of the Serumosmolalität with the following formula:
    • Osmolalität [osmol/kg] = 1.86 x well + [mmol/l] + glucose [mmol/l]+ urea [mmol/l] + 9

or

    • Osmolalität [osmol/kg] = 2 x (well + [mmol/l] + K + [mmol/l]) + glucose/18 [mg/dl] + urea/6 [mg/dl]


the reference range for the Osmolalität in the serum is about 280-310 mosmol/kg. ThoseValues for 24-Stunden-Urin are with 50-1200 mosmol/kg.

  • Urinosmolalität: normally after 12stündigem Dursten = 3fache of the Serumosmolalität, corresponds to 800-900 mosmol/kg
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pathophysiology

with ADH - lack comes it to a strong loss of water, that diabetes insipidus centralis. With lackor the same symptoms develop for mutation of the V2-Rezeptors at the kidney however speak one then of diabetes insipidus renalis. Both can lead to an uncontrolled loss of water of up to 20 litres per day.

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overproduction and under-production

withSyndrome of the inadäquaten ADH (overproduction) secretion comes it to the decreased water elimination and to a Hyponatriämie. This syndrome can adjust itself with cancer of the lungs, whose increases cells and ADH inadequate-proves or ADH similar materials produce.

With under-production one drinks excessively much(starting from 4 litres up to 12 litres per day) and 5 to 25 litres urine separates. One must leave therefore increased and frequent urine (Polyurie and Pollakisurie).

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therapy

of the diabetes insipidus centralis can by the giftby ADH to be treated.

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ADH as medicine material

Vasopressin is used as strongly blood pressure-increasing substance also successfully with the Reanimation of a patient with heart cycle stop (unique gift of 40 U). As was shown in studies, ADH with less worksSide effects as adrenalin. Up to the end of the yearly 2005 Vasopressin had as emergency medicine still no permission in Germany, in the meantime may it with the Reanimation be used now.

There however the data situation regarding a survival advantage compared with Adrenalin for the moment of the European Resuscitation Council as insufficient is regarded, gives it in the Reanimationsrichtlinien of 2005 neither a recommendation for nor against the gift of ADH.

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alcohol

drinking alcohol (ethanol) restrains productionof Vasopressin (ADH), which in the body for it is responsible, the water restrainable. That is the reason for the fact that one visits the toilet more frequently after extensive consumption of alcohol. Lack of liquid leads to headache and to the “Nachdurst”, as soon as the inhibition of the ADHs by ethanoldiminishes.

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