Decreased secretion of antidiuretic hormone (ADH)

Introduction Antidiuretic hormone (also known as vasopressin) is a 9-peptide hormone secreted by the neurons of the suprachiasmatic and paraventricular nucleus of the hypothalamus, which is released by the hypothalamic-pituitary bundle after reaching the neurohypophysis. Its main function is to improve the permeability of the distal convoluted tubules and collecting tubes to water and promote the absorption of water. It is a key regulating hormone for urine concentration and dilution. In addition, the hormone enhances the permeability of the inner medullary collecting duct to urea. After drinking plenty of water, the blood is diluted, the crystal osmotic pressure is reduced, and the anti-urea urea secretion is reduced.

Cause

Urination is not smooth

1. Edema disease: refers to excessive accumulation of body fluids in the extravascular tissue space. It is one of the common clinical symptoms. Edema is a manifestation of systemic gasification dysfunction, with lung, spleen, kidney, and trifocal organs. closely related. According to the symptoms, there are two types, which are common in nephritis, pulmonary heart disease, cirrhosis, nutritional disorders and endocrine disorders.

2, essential hypertension.

3. Central or renal diabetes insipidus.

4, kidney stone disease is mainly used to prevent stones containing calcium salts.

an examination

Related inspection

Antidiuretic water load ADH inhibition test urine dilution test serum sodium (Na+, Na) plasma antidiuretic hormone (ADH)

Pass urine test and blood test. Among them, urine examination mainly checks pH, urine specific gravity, urinary biliary, occult blood, white blood cells, urine protein, urine sugar, bilirubin, ketone body, urinary red blood cells, urine color, urinary red blood cells, occult blood, and white blood cells. Blood tests mainly check blood routine, erythrocyte sedimentation rate, plasma protein, blood urea nitrogen, creatinine, and humoral immunity. In addition, ECG, cardiac function measurement, kidney b ultrasound and other laboratory tests.

Differential diagnosis

1 changes in plasma crystal osmotic pressure can significantly affect the secretion of vasopressin: a lot of sweating. Severe vomiting or diarrhea, etc., when the body loses water, the plasma crystal osmotic pressure increases, which can cause the secretion of antidiuretic hormone to increase, so that the reabsorption of water by the kidney is significantly enhanced, resulting in urine concentration and decreased urine output. On the contrary, after drinking plenty of water, the urine is diluted and the amount of urine is increased, so that excess water in the body is excreted.

For example, after a normal person drinks 100ml of water at a time, about half an hour, the amount of urine begins to increase. By the end of the first hour, the amount of urine can reach the highest value; then the amount of urine decreases, and the amount of urine returns to the original level after 2-3 hours. If you are drinking isotonic saline (0.9NaCI solution), the amount of urine will not change as you drink water. This phenomenon of increasing the amount of urine caused by drinking plenty of water is called water diuresis, which is a commonly used test for clinically testing the ability of kidney to dilute.

2 changes in circulating blood volume can reflect the release of vasopressin reflexively: when the blood volume is too much, the left atrium is dilated, stimulating the volume receptor, and the afferent impulse passes through the vagus nerve afferent center, inhibiting the hypothalamus-posterior pituitary The system releases vasopressin, which causes diuresis, and the normal blood volume is restored due to excess water. When the blood volume decreases, the opposite change occurs. Increased arterial blood pressure, stimulate carotid sinus baroreceptors, can reflexively inhibit the release of vasopressin.

In addition, atrial natriuretic peptide can inhibit the secretion of antidiuretic hormone, angiotensin II can stimulate its secretion. The main factors regulating vasopressin are plasma crystal osmotic pressure and circulating blood volume, and arterial blood pressure.

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