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Vasopressin (Antidiuretic Hormone) : Renal physiology USMLE Step 1

Vasopressin (ADH) is a hormone produced in the hypothalamus and stored in the posterior pituitary gland.
Vasopressin is water soluble, so it travels unbound in circulation; vasopressin binds to target tissues by using various G protein–coupled receptors.
Vasopressin’s main actions serve to raise blood pressure and expand blood volume.
Vasopressin causes the contraction of vascular smooth muscle cells, leading to vasoconstriction and increased blood pressure.
Vasopressin causes insertion of aquaporins into the principal cells in the renal cortical collecting duct, allowing water to be reabsorbed from the tubule into the blood to increase blood volume.
If ADH is low, aquaporins are not inserted into the principal cells, so water is not reabsorbed; as a result, the kidney excretes water, lowering the urine osmolality and increasing the serum osmolality.
Vasopressin causes the release of von Willebrand factor from vascular endothelial cells, stimulating platelet aggregation.
An increase in serum osmolality, a decrease in effective circulating volume, or an increase in angiotensin II stimulates ADH release.
Cortisol and atrial natriuretic peptide inhibit ADH activity.

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