What is the role of serum ADH measurement in the workup of hyponatremia?

Updated: Dec 28, 2018
  • Author: Kartik Shah, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Serum ADH levels are not routinely used in the evaluation of hyponatremia because the assay is technically difficult and not widely available on a stat basis. A serum peptide known as copeptin has been studied in the evaluation of hyponatremia. Copeptin is the C terminal portion of provasopressin and is released in equimolar amounts with vasopressin (ADH). Early research suggested that copeptin might be valuable in the differential diagnosis of hyponatremia, but subsequent studies cast doubt on the additional utility copeptin provides beyond the urine and serum assays already routinely used, especially in the initial approach to hyponatremia in the emergency department. [21, 22]


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