Vasopressin and disorders of water balance: the physiology and pathophysiology of vasopressin

Ann Clin Biochem 2007;44:417-431
© 2007 Association for Clinical Biochemistry


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Review Articles

S G Ball

The Medical School, University of Newcastle upon Tyne, Framlington Place, Newcastle upon Tyne NE22 4HH, UK

Disorders of water balance are a common feature of clinicalpractice. An understanding of the physiology and pathophysiologyof the key endocrine regulator of water balance vasopressin(VP) is key to diagnosis and management of these disorders.Diabetes insipidus is the result of a lack of VP or (less commonly)resistance to the renal effects of the hormone. Diagnostic testingcan clarify aetiology and direct appropriate management. VPproduction can be associated with hyponatraemia. A comprehensiveassessment of cardiovascular status and pharmacological influencesare needed in these circumstances to differentiate between primary(inappropriate) and secondary (appropriate) physiological VPproduction. As with diabetes insipidus, diagnostic testing canhelp define the aetiology of hyponatraemia and direct appropriatemanagement. Patients with disorders of water balance benefitfrom a joint clinical and laboratory medicine approach to diagnosisand management.

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