Hemodynamic and Coagulation Responses to 1-Desamino[8-D-Arginine] Vasopressin in Patients with Congenital Nephrogenic Diabetes Insipidus

Abstract

The antidiuretic hormone arginine vasopressin interacts with two types of receptors: V₁, which mediates the effects of vasopressin on vascular smooth muscle, and V₂, which mediates the antidiuretic effects on renal tubules. Resistance of the renal tubules to arginine vasopressin and to the antidiuretic V₂-specific agonist 1-desamino[8-D-arginine] vasopressin (dDAVP) occurs in congenital nephrogenic diabetes insipidus, a rare X-linked disease, although the V1-receptor responses remain intact. The extrarenal actions of dDAVP in normal persons are a decrease in blood pressure, an increase in plasma renin activity, and stimulation of the release of factor VIIIc and von Willebrand factor.