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Physiology
Renal system anatomy and physiology
Hydration
Body fluid compartments
Movement of water between body compartments
Renal clearance
Glomerular filtration
TF/Px ratio and TF/Pinulin
Measuring renal plasma flow and renal blood flow
Regulation of renal blood flow
Tubular reabsorption and secretion
Tubular secretion of PAH
Tubular reabsorption of glucose
Urea recycling
Tubular reabsorption and secretion of weak acids and bases
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
Renin-angiotensin-aldosterone system
Sodium homeostasis
Potassium homeostasis
Phosphate, calcium and magnesium homeostasis
Osmoregulation
Sodium homeostasis
Antidiuretic hormone
Kidney countercurrent multiplication
Free water clearance
Vitamin D
Erythropoietin
Physiologic pH and buffers
Buffering and Henderson-Hasselbalch equation
The role of the kidney in acid-base balance
Acid-base map and compensatory mechanisms
Respiratory acidosis
Metabolic acidosis
Plasma anion gap
Respiratory alkalosis
Metabolic alkalosis
Antidiuretic hormone
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in diabetes insipidus p. 344
hypothalamus synthesis p. 511
kidney effects p. 614
nephron physiology p. 609
pituitary gland and p. 339
SIADH and p. 344
signaling pathways of p. 353
antidiuretic hormone regulation of p. 340
antidiuretic hormone in p. 340
antidiuretic hormone regulation of p. 340
Ursula Florjanczyk, MScBMC
Jahnavi Narayanan, MBBS
Evan Debevec-McKenney
Antidiuretic hormone, or ADH, is a peptide hormone that is anti- or against -diuresis which is excessive urine production.
Antidiuretic hormone is also called vasopressin because it causes vasoconstriction - constriction of blood vessels.
So antidiuretic hormone prevents making too much urine, which leads to water retention, and vasoconstriction, and together these two actions help increase the blood pressure.
Now, the brain has two interconnected structures: the hypothalamus and the pituitary gland. These two structures are connected by the pituitary stalk.
The hypothalamus is a part of the brain that contains several nuclei, or clusters of neurons. And two of these nuclei, the paraventricular and supraoptic nuclei, contain neurons that secrete ADH.
When ADH is produced, it travels down the axons of these neurons, and these axons have small dilations called Herring bodies, which is where ADH is stored.
When the body needs more ADH, the stored hormone is released and continues down the axon through the pituitary stalk.
From there it’s released into the posterior pituitary gland which is interstitial tissue near capillary beds, so that the ADH can easily enter the bloodstream.
Let’s say that it's a super sunny day out and you forget to bring water with you. Well first, as you walk around, you’re constantly losing water through sweat as well as water vapor from your mouth and nose as you breathe out - these are insensible water losses. Without drinking water, you can quickly get dehydrated. This causes your plasma osmolarity to increase, because the fluid levels in your blood drop, but the total number of solute particles remains roughly the same.
Now, two things now begin to happen simultaneously. First, a region in the brain called the anterior hypothalamus has a cluster of neurons called supraoptic nuclei, which have osmoreceptors that sense even tiny changes in osmolarity, as small as 1 mOsm/L. These neurons are always sampling the blood that passes by and they have a special channel called aquaporin 4 which allows water to freely enter or exit the cell.
Antidiuretic hormone (ADH), also known as vasopressin, is a hormone that regulates water and electrolytes (e.g. sodium) balance. It does so by increasing water reabsorption into the bloodstream by acting on the kidneys nephrons. ADH is synthesized in the hypothalamus, and released into circulation from the posterior pituitary gland. Its secretion is triggered by states of hypovolemia like hemorrhage, dehydration and thirst.
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