Utility and Safety of Tolvaptan in Cirrhotic Patients with Hyponatremia: a Prospective Cohort Study
Ann. hepatol
;
16(1): 123-132, Jan.-Feb. 2017. graf
Artículo
en Inglés
| LILACS
| ID: biblio-838094
ABSTRACT
Abstract Introduction and aim. Hyponatremia is common in patients with decompensated cirrhosis and is associated with increased mortality. Tolvaptan, a vasopressor V2 receptor antagonist, can increase free wáter excretion, but its efficacy and safety in cirrhotic patients remain unclear. Material and methods. We studied the usage and safety of tolvaptan in cirrhotic patients in a real-life, non-randomized, multicenter prospective cohort study. Forty-nine cirrhotic patients with hyponatremia were treated with tolvaptan 15 mg daily, and 48 patients not treated with tolvaptan in the same period served as controls. Improvement in serum sodium level was defined as an increase in serum sodium from < 125 to ≥ 125 mmol/L or from 125-134 to ≥ 135 mmol/L on day 7. Results. Twenty-three (47%) patients in the tolvaptan group and 17 (35%) in the control group had normal serum sodium on day 7 (p = 0.25). Serum sodium improved in 30 (61%) patients in the tolvaptan group and 17 (35%) patients in the control group (p = 0.011). Adverse events occurred in 46-47% of patients in both groups, and tolvaptan was not associated with worsened liver function. No patient with normal serum sodium on day 7 died within 30 days of treatment, whereas 16% of those with persistent hyponatremia died (p = 0.0019). Conclusion. In conclusion, short-term tolvaptan treatment is safe and can improve serum sodium level in cirrhotic patients with hyponatremia. Normalization of serum sodium level is associated with better survival.
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Disponible
Índice:
LILACS (Américas)
Asunto principal:
Sodio
/
Benzazepinas
/
Antagonistas de los Receptores de Hormonas Antidiuréticas
/
Hiponatremia
/
Cirrosis Hepática
Tipo de estudio:
Ensayo Clínico Controlado
/
Estudio diagnóstico
/
Estudio de etiología
/
Estudio observacional
/
Factores de riesgo
Límite:
Anciano
/
Humanos
País/Región como asunto:
Asia
Idioma:
Inglés
Revista:
Ann. hepatol
Asunto de la revista:
Gastroenterologia
Año:
2017
Tipo del documento:
Artículo
País de afiliación:
China
Institución/País de afiliación:
Capital Medical University/CN
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