Vasopressin
Vasopressin (antidiuretic hormone, AVP)
Also known as: ADH, Vasostrict
The natural water-retention hormone, FDA-approved as a drug to raise blood pressure in critically ill patients.
Overview
Vasopressin, or antidiuretic hormone, regulates water balance by concentrating urine and also constricts blood vessels. As a drug (Vasostrict) it is FDA-approved to raise blood pressure in vasodilatory shock. It is also studied for its role in social behavior and stress. Its analogue desmopressin is used for bedwetting and diabetes insipidus.
Mechanism of action
Activates V2 receptors in the kidney to retain water and V1 receptors on blood vessels to raise blood pressure.
Key studies & citations
- Human2008
Vasopressin versus norepinephrine infusion in patients with septic shock (VASST)
778 patients: 28-day mortality 35.4% with low-dose vasopressin versus 39.3% with norepinephrine, not significantly different.
New England Journal of Medicine - Human2016
Effect of early vasopressin vs norepinephrine on kidney failure in patients with septic shock: the VANISH randomized clinical trial
409 patients: early vasopressin did not improve kidney-failure-free days, though renal replacement therapy use was lower.
JAMA
Frequently asked questions
How is vasopressin different from desmopressin?
Desmopressin is a modified analogue with mainly water-retention effects and little blood-pressure action, used for bedwetting and diabetes insipidus. Vasopressin itself also raises blood pressure.