Background information
Adrenomedullin (ADM), a vasodilator produced by most contractile cells, is characterized by persistent hypotensive activity. ADM is involved in the regulation of fluid and electrolyte homeostasis and in the maintenance of cardiovascular functioning. In hypertensive patients, the level of ADM in plasma is up-regulated. Natriuresis is a common systemic manifestation of aneurysmal subarachnoid hemorrhage. ADM has strong natriuretic actions. ADM-induced natriuresis is caused by an increase in glomerular filtration rate and a decrease in distal tubular sodium reabsorption. ADM is present both in the periphery and brain, and can exert central effects such as decreasing food ingestion.