Limited Efficacy of Tolvaptan in Patients with Cirrhosis and Severe Hyponatremia: Real-Life Experience

作者：Pose Elisa; Sola Elsa; Piano Salvatore; Gola Elisabetta; Graupera Isabel; Guevara Monica; Cardenas Andres; Angeli Paolo; Gines Pere

来源：American Journal of Medicine, 2017, 130(3): 372-375.

DOI：10.1016/j.amjmed.2016.09.011

• Cirrhosis
• Hypervolemic hyponatremia
• Hyponatremia
• Tolvaptan
• Vasopressin

BACKGROUND: Vaptans, vasopressin selective V2-receptor antagonists, represent the first pharmacologic approach to the treatment of hypervolemic hyponatremia in cirrhosis. However, information on the use of vaptans for patients with cirrhosis and hyponatremia in a real- life scenario is limited. Therefore, this study evaluated the effect of tolvaptan on serum sodium in patients with cirrhosis and severe hypervolemic hyponatremia.
METHODS: Nine patients with cirrhosis and serum sodium <= 125 mEq/L were included.
RESULTS: Only 2 of the 9 patients (22%) gained an increase in serum sodium > 130 mEq/L that persisted throughout treatment. In the remaining patients, serum sodium did not change or increased during the first days but decreased thereafter despite continuation of treatment. Only 1 patient developed hyperkalemia as a side effect.
CONCLUSIONS: The efficacy of tolvaptan in patients with cirrhosis and severe hypervolemic hyponatremia seems to be limited.

• 出版日期2017-3