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Vasopressin, Diabetes Insipidus, the Syndrome of Inappropriate Antidiuresis and Hyponatraemia pp.123-144 $100.00
Authors:  (M.J. Hannon, Academic Department of Endocrinology, Beaumont Hospital/RCSI Medical School, Dublin, Ireland)
Abstract:
In humans, normal cellular function is dependent on normal tonicity of the extracellular fluid. In order to maintain normal extracellular tonicity there needs to be a sophisticated regulation of water homeostasis the process of osmoregulation. Osmoregulation is dependent on the integration of the production and action of the posterior pituitary hormone vasopressin, the antidiuretic actions of vasopressin on the renal collecting ducts, and normal regulation of thirst and fluid intake. Disturbances in this physiological mechanism can result in diabetes insipidus or the Syndrome of Inappropriate Antidiuresis (SIAD). SIAD is one of the most common causes of hyponatraemia, which is the most frequent electrolyte imbalance found in hospital inpatients and is a major cause of morbidity and mortality. In this chapter, we will review the physiological production and action of vasopressin and the interaction with the regulation of thirst. We will then apply these physiological principles to the pathophysiological mechanisms which are the basis for diabetes insipidus and SIAD, explaining in detail the aetiologies, clinical features and treatments of these conditions. Finally, we will review the topic of hyponatraemia due to SIAD, its various causes, symptoms and management, with particular reference to the new class of selective vasopressin receptor antagonists, the vaptans. 


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Vasopressin, Diabetes Insipidus, the Syndrome of Inappropriate Antidiuresis and Hyponatraemia pp.123-144