Ball S G
The Medical School, University of Newcastle upon Tyne, Framlington Place, Newcastle upon Tyne NE22 4HH, UK.
Ann Clin Biochem. 2007 Sep;44(Pt 5):417-31. doi: 10.1258/000456307781646030.
Disorders of water balance are a common feature of clinical practice. An understanding of the physiology and pathophysiology of the key endocrine regulator of water balance vasopressin (VP) is key to diagnosis and management of these disorders. Diabetes insipidus is the result of a lack of VP or (less commonly) resistance to the renal effects of the hormone. Diagnostic testing can clarify aetiology and direct appropriate management. VP production can be associated with hyponatraemia. A comprehensive assessment of cardiovascular status and pharmacological influences are needed in these circumstances to differentiate between primary (inappropriate) and secondary (appropriate) physiological VP production. As with diabetes insipidus, diagnostic testing can help define the aetiology of hyponatraemia and direct appropriate management. Patients with disorders of water balance benefit from a joint clinical and laboratory medicine approach to diagnosis and management.
水平衡紊乱是临床实践中的常见特征。了解水平衡的关键内分泌调节因子抗利尿激素（VP）的生理学和病理生理学是诊断和管理这些紊乱的关键。尿崩症是缺乏VP或（较不常见）对该激素的肾脏作用产生抵抗的结果。诊断测试可以明确病因并指导适当的管理。VP的产生可能与低钠血症有关。在这些情况下，需要对心血管状态和药物影响进行全面评估，以区分原发性（不适当）和继发性（适当）生理性VP产生。与尿崩症一样，诊断测试有助于确定低钠血症的病因并指导适当的管理。水平衡紊乱患者受益于联合临床和实验室医学方法进行诊断和管理。
