From the Research
Yes, DDAVP (desmopressin) can increase BNP (brain natriuretic peptide) levels in the body, as evidenced by a recent study published in 2021 1.
Mechanism of Action
DDAVP is a synthetic analog of vasopressin that acts on V2 receptors in the kidneys, promoting water reabsorption and reducing urine output. When DDAVP is administered, it causes water retention which can lead to increased plasma volume and mild hemodilution. This volume expansion puts additional pressure on the heart, particularly the ventricles, which respond by releasing more BNP.
Clinical Implications
BNP is produced primarily by ventricular cardiomyocytes in response to stretching from increased volume or pressure. The hormone functions as a natural diuretic, promoting sodium and water excretion to counterbalance the volume-retaining effects of DDAVP. This relationship is particularly important in clinical settings where patients receive DDAVP for conditions like diabetes insipidus, von Willebrand disease, or hemophilia A, as the resulting fluid retention may affect cardiac function and BNP measurements.
Key Findings
A study published in the Indian Journal of Pediatrics in 2021 found that initiation of DDAVP therapy in patients with Wolfram syndrome caused abrupt volume expansion, resulting in high secretion of ANP and/or BNP, which in turn led to secondary mineralocorticoid deficiency and acute hyponatremia 1.
Comparison with Other Studies
While other studies have investigated the effects of DDAVP on BNP levels, the 2021 study provides the most recent and highest-quality evidence on this topic. For example, a study published in 1997 found that desmopressin treatment increased BNP mRNA levels in the left auricle of Brattleboro rats 2. However, this study is older and has a smaller sample size compared to the 2021 study.