Patient education: Arginine vasopressin disorders (The Basics)

What are arginine vasopressin disorders? — These are conditions that cause the body to make too much urine. "Arginine vasopressin," or "AVP," is the name of a hormone that helps balance the amount of fluid in the body. It does this by causing the kidneys to make the right amount of urine. AVP is also called "antidiuretic hormone."

AVP disorders happen when there is a problem with this hormone.

There are 2 types of AVP disorder:

●AVP deficiency, or "AVP-D" – In people with this type, the body doesn't make enough AVP to keep the amount of fluid in balance.

●AVP resistance, or "AVP-R" – In people with this type, the body makes enough AVP, but the kidneys don't respond to it.

AVP disorders used to be called "diabetes insipidus." This was confusing because the conditions are very different from diabetes mellitus, which is what most people mean when they say "diabetes." Diabetes mellitus is a disorder that affects how the body uses sugar.

What are the symptoms of an AVP disorder? — The symptoms are:

●Needing to urinate often, sometimes in the middle of the night

●Making large amounts of urine

●Feeling very thirsty

Is there a test for AVP disorders? — Yes. If your doctor thinks that you might have this condition, they will order tests. This can tell them if you have an AVP disorder, and if so, which type.

Tests might include:

●A test to measure how much urine your body makes – For this test, you stop drinking fluids for 2 to 3 hours. Then, the doctor records how much urine you make over the next 2 hours and possibly longer.

●Tests to measure certain substances in your urine or blood

Your doctor might give you a medicine that's often used to treat the condition. Your body's response will help show which type of disorder you have.

How are AVP disorders treated? — The right treatment for you depends on which type you have. In general, all of the treatments work by reducing the amount of urine the body makes.

●If you have AVP-D, your doctor will probably prescribe a medicine called desmopressin (brand names: DDAVP, Stimate). It comes as a nasal spray, a pill, or a shot under the skin. It replaces the hormone missing from your body. Doctors sometimes prescribe other medicines, too.

●If you have AVP-R, the treatment options are different. With this type, the kidneys usually don't respond to AVP because they are damaged. Often, the kidney damage is caused by other health problems or the medicines used to treat them. If possible, treating the other health problem or stopping the medicines can help. Certain medicines, including some used to treat high blood pressure, might also help.

Your doctors might also recommend a low-salt, low-protein diet. This might help control symptoms.

Is there anything I can do on my own to feel better?

●Some people feel better if they eat a diet low in sodium (the main ingredient in salt) and low in protein. These diet changes will help you make less urine. You can drink when you are thirsty.

If you're not sure what to eat, talk to your doctor or nurse. They might refer you to a dietitian (food expert) who can help you.

●Another helpful tip is called "double voiding." This involves urinating more than once to empty your bladder. After you urinate, wait 10 to 15 minutes, and then urinate again to empty your bladder completely.

What if I want to get pregnant? — Most people with an AVP disorder can have normal pregnancies. But the condition can get worse during pregnancy. Desmopressin is safe to take during pregnancy.

When should I call the doctor? — If you are being treated for an AVP disorder, see your doctor or nurse right away if you have:

●Nausea or vomiting

●Dizziness of fainting

●Trouble staying awake

●Problems with balance

●A seizure

These symptoms could mean that your medicine dose needs to be changed.

More on this topic

Patient education: Low-sodium diet (The Basics)

Patient education: Low-sodium diet (Beyond the Basics)