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Utility and safety of Tolvaptan in cirrhotic patients with hyponatremia: A prospective cohort study(Open Access)

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机构： [1]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China. [2]Beijing Di Tan Hospital, Capital Medical University, Beijing, China. [3]Department of Gastroenterology and Hepatology, Beijing You’an Hospital affiliated with Capital Medical University, Beijing, China. [4]Department of Gastroenterology, Zhujiang Hospital, Southern Medical University, Guangzhou, China. [5]First Teaching Hospital, Tianjin University of Traditional Chinese Medicine, Tianjin, China. [6]Department of Integrative Medical Center, 302 Military Hospital of People’s Liberation Army, Beijing, China. [7]Hospital 85 People’s Liberation Army of China, Shanghai, China. [8]Shanghai Public Health Clinical Center Affiliated to Fudan University, Shanghai, China. [9]Tianjin Second People-s Hospital, Tianjin First Center Hospital, Tianjin, China. [10]Changhai Hospital, The Second Military Medical University, Shanghai, China. [11]Renji Hospital Shanghai, Jiao Tong University School of Medicine, Shanghai, China. [12]Peking University First Hospital, Beijing, China. [13]Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China. [14]Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin, China. [15]Tongren Hospital Shanghai, Jiaotong University School of Medicine, Shanghai, China. [16]Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China. [17]State Key Laboratory of Digestive Disease. [18]Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.

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关键词： Antidiuretic hormone receptor antagonists Liver failure Sodium Spironolactone Vasopressin receptors

摘要：

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 water excretion, but its efficacy and safety in cirrhotic patients remain unclear. Material and methods. We studied the usage and satety of tolvaptan in cirrhotic patients in a real-lite, 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% ot 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% ot 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 ot serum sodium level is associated with better survival. © 2017, Fundacion Clinica Medica Sur. All rights reserved.

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出版当年[2016]版：

大类 | 4 区医学

小类 | 4 区胃肠肝病学

最新[2023]版：

大类 | 3 区医学

小类 | 4 区胃肠肝病学

JCR分区：

出版当年[2015]版：

Q4 GASTROENTEROLOGY & HEPATOLOGY

最新[2023]版：

Q2 GASTROENTEROLOGY & HEPATOLOGY

影响因子： 3.7 最新[2023版] 3.1 最新五年平均 1.816 出版当年[2015版] 1.807 出版当年五年平均 2.065 出版前一年[2014版] 1.678 出版后一年[2016版]

第一作者：

第一作者机构： [1]Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

通讯作者：

通讯机构： [17]State Key Laboratory of Digestive Disease. [18]Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China. [*1]Department of Medicine and Therapeutics Faculty of Medicine, The Chinese University of Hong Kong

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Utility and safety of Tolvaptan in cirrhotic patients with hyponatremia: A prospective cohort study(Open Access)

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