Antidiuretic Hormone

Antidiuretic Hormone is a topic covered in the Davis's Lab & Diagnostic Tests.

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Synonym/Acronym:
Vasopressin, arginine vasopressin hormone, ADH.

Rationale
To evaluate disorders that affect urine concentration related to fluctuations of ADH secretion, such as diabetes insipidus.

Patient Preparation
There are no food, fluid, or medication restrictions unless by medical direction. The patient should be encouraged to be calm and in a sitting position for specimen collection.

Normal Findings
Method: Radioimmunoassay.

AgeAntidiuretic Hormone*SI Units (Conventional Units × 0.923)
NewbornLess than 1.5 pg/mLLess than 1.4 pmol/L
Child (normally hydrated)0.5–1.7 pg/mLLess than 0.5–1.6 pmol/L
Adult (normally hydrated)1–5 pg/mL0.9–4.6 pmol/L
*Conventional units.

Recommendation

This test should be ordered and interpreted with results of a serum osmolality.

Serum Osmolality*Antidiuretic HormoneSI Units (Conventional Units × 0.923)
270–280 mOsm/kgLess than 1.5 pg/mLLess than 1.4 pmol/L
280–285 mOsm/kgLess than 2.5 pg/mLLess than 2.3 pmol/L
285–290 mOsm/kg1–5 pg/mL0.9–4.6 pmol/L
290–295 mOsm/kg2–7 pg/mL1.8–6.5 pmol/L
295–300 mOsm/kg4–12 pg/mL3.7–11.1 pmol/L
*Conventional units.

Critical Findings and Potential Interventions

Effective treatment of the syndrome of inappropriate antidiuretic hormone production (SIADH) depends on identifying and resolving the cause of increased ADH production. Signs and symptoms of SIADH are the same as those for hyponatremia, including irritability, tremors, muscle spasms, convulsions, and neurological changes. The patient has enough sodium, but it is diluted in excess retained water.

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