ADH is a hormone secreted by neurohypophysis that plays different roles based on the target organ. At the renal level, this peptide is capable of causing electrolyte-free water absorption, thus playing a key role in the hydro-electrolytic balance. There are pathologies and disorders that jeopardize this balance and, in this field, ADH receptor inhibitors such as Vaptans could play a key role. By inhibiting the activation pathway of vasopressin, they are potentially useful in euvolemic and hypervolemic hypotonic hyponatremia. However, clinical trials in heart failure have not given favourable results on clinical outcomes. Even in SIADH, despite their wide use, there is no agreement by experts on their use.
Since vaptans inhibit the cAMP pathway in tubular cells, their use has been proposed to inhibit cystogenesis. A clinical trial has shown favourable effects on ADPKD progression.
Because vaptans have been shown to be effective in models of renal cysts disorders other than ADPKD, their use has been proposed in diseases such as nephronophthisis and recessive autosomal polycystic disease. Other possible uses of vaptans could be in kidney transplantation and cardiorenal syndrome.
Due to the activity of ADH in coagulation and haemostasis, ADH’s activation pathway by Desmopressin Acetate could be a useful strategy to reduce the risk of bleeding in biopsies in patients with haemorrhagic risk.
Keyword: vasopressin, vaptans, hyponatremia, ADPKD, biopsy
ADH ni homoni inayotokana na neurohypophysis ambayo hucheza majukumu tofauti kulingana na kiungo cha lengo. Katika ngazi ya figo, peptide hii ina uwezo wa kusababisha electrolyte-free maji kunyonya, hivyo kucheza jukumu muhimu katika usawa hydro-electrolytic. Kuna magonjwa na matatizo ambayo yanaharibu usawa huu na, katika uwanja huu, vizuizi vya receptor za ADH kama vile Vaptans vinaweza kucheza jukumu muhimu. Kwa kuzuia njia ya uanzishaji wa vasopressin, zinaweza kuwa na manufaa katika euvolemic na hypervolemic hypotonic hyponatremia. Hata hivyo, majaribio ya kliniki katika kushindwa kwa moyo hayakutoa matokeo mazuri juu ya matokeo ya kliniki. Hata katika SIADH, licha ya matumizi yao ya kina, hakuna makubaliano na wataalamu juu ya matumizi yao. Vaptans huzuia njia ya cAMP katika seli za tubular, na matumizi yao yamependekezwa kuzuia cystogenesis. Utafiti wa kliniki umeonyesha athari nzuri juu ya maendeleo ya ADPKD. Vaptan ni dawa ya kawaida ya kuambukiza ugonjwa wa kidonda cha figo (ADPDK) na inaweza kutumika kwa matibabu ya ugonjwa wa nephroptosis na autosomal polycystic. Matumizi mengine yanayowezekana ya vaptans yanaweza kuwa katika upandikizaji wa figo na ugonjwa wa cardiorenal. Kwa sababu ya utendaji wa ADH katika coagulation na haemostasis, njia ya uanzishaji wa ADH na Desmopressin Acetate inaweza kuwa mkakati muhimu wa kupunguza hatari ya kutokwa na damu katika biopsies katika wagonjwa wenye hatari ya kutokwa na damu. Vipimo vya vasopressin, vaptans, hyponatremia, ADPKD, na biopsy