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Year 2020, Volume: 2 Issue: 2, 43 - 47, 29.04.2020
https://doi.org/10.46310/tjim.706226

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References

  • Verbalis JG. Hyponatremia: endocrinologic causes and consequences of therapy. Trends Endocrinol Metab. 1992;3(1):1-7.
  • Park GH, Lee CM, Song JW, Jung MC, Kim JK, Song YR, et al. Comparison of tolvaptan treatment between patients with the SIADH and congestive heart failure: a single-center experience. Korean J Intern Med. 2018;33(3):561-7.
  • Urso C, Brucculeri S, Caimi G. Employment of vasopressin receptor antagonists in management of hyponatraemia and volume overload in some clinical conditions. J Clin Pharm Ther. 2015;40(4):376-85.
  • Lilly LS, Dzau VJ, Williams GH, Rydstedt L, Hollenberg NK. Hyponatremia in congestive heart failure: implications for neurohumoral activation and responses to orthostasis. J Clin Endocrinol Metab. 1984;59(5):924-30.
  • Gralla RJ, Ahmad F, Blais JD, Chiodo J 3rd, Zhou W, Glaser LA, et al. Tolvaptan use in cancer patients with hyponatremia due to the syndrome of inappropriate antidiuretic hormone: a post hoc analysis of the SALT-1 and SALT-2 trials. Cancer Med. 2017;6(4):723-9.
  • Nemerovski C, Hutchinson DJ. Treatment of hypervolemic or euvolemic hyponatremia associated with heart failure, cirrhosis, or the syndrome of inappropriate antidiuretic hormone with tolvaptan: a clinical review. Clin Ther. 2010;32(6):1015-32.
  • Nielsen S, Kwon TH, Christensen BM, Promeneur D, Frøkiaer J, Marples D. Physiology and pathophysiology of renal aquaporins. J Am Soc Nephrol. 1999;10(3):647-63.
  • Schrier RW, Sharma S, Shchekochikhin D. Hyponatraemia: more than just a marker of disease severity? Nat Rev Nephrol. 2013;9(1):37-50.
  • Miyazaki T, Fujiki H, Yamamura Y, Nakamura S, Mori T. Tolvaptan, an orally active vasopressin V(2)-receptor antagonist - pharmacology and clinical trials. Cardiovasc Drug Rev. 2007;25(1):1-13.
  • Costello-Boerrigter LC, Smith WB, Boerrigter G, Ouyang J, Zimmer CA, Orlandi C, et al. Vasopressin-2-receptor antagonism augments water excretion without changes in renal hemodynamics or sodium and potassium excretion in human heart failure. Am J Physiol Renal Physiol. 2006;290(2):F273-8.
  • Kinugawa K, Sato N, Inomata T. Effects of Tolvaptan on Volume Overload in Patients with Heart Failure. Int Heart J. 2018;59(6):1368-77.
  • Gheorghiade M, Niazi I, Ouyang J, Czerwiec F, Kambayashi J, Zampino M, et al. Vasopressin V2-receptor blockade with tolvaptan in patients with chronic heart failure: results from a double-blind, randomized trial. Circulation. 2003;107(21):2690-6.
  • Dasta JF, Sundar S, Chase S, Lingohr-Smith M, Lin J. Economic impact of tolvaptan treatment vs. fluid restriction based on real-world data among hospitalized patients with heart failure and hyponatremia. Hosp Pract. 2018;46(4):197-202.
  • Alskaf E, Tridente A, Al-Mohammad A. Tolvaptan for Heart Failure, Systematic Review and Meta Analysis of Trials. J Cardiovasc Pharmacol. 2016;68(3):196-203.
  • Gheorghiade M, Konstam MA, Burnett JC Jr, Grinfeld L, Maggioni AP, Swedberg K, et al. Short-term clinical effects of tolvaptan, an oral vasopressin antagonist, in patients hospitalized for heart failure: the EVEREST Clinical Status Trials. JAMA. 2007;297(12):1332-43.
  • Matsue Y, Suzuki M, Seya M, Iwatsuka R, Mizukami A, Nagahori W, et al. Tolvaptan reduces the risk of worsening renal function in patients with acute decompensated heart failure in high-risk population. J Cardiol. 2013;61(2):169-74.
  • Matsue Y, Suzuki M, Nagahori W, Yoshida K, Onishi Y, Satoh Y, et al. Clinical effectiveness of tolvaptan in patients with acute decompensated heart failure and renal failure: design and rationale of the AQUAMARINE study. Cardiovasc Drugs Ther. 2014;28(1):73-7.
  • Schrier RW, Gross P, Gheorghiade M, Berl T, Verbalis JG, Czerwiec FS, et al. Tolvaptan, a selective oral vasopressin V2-receptor antagonist, for hyponatremia. N Engl J Med. 2006;355(20):2099-112.
  • Verbalis JG, Adler S, Schrier RW, Berl T, Zhao Q, Czerwiec FS; SALT Investigators. Efficacy and safety of oral tolvaptan therapy in patients with the syndrome of inappropriate antidiuretic hormone secretion. Eur J Endocrinol. 2011;164(5):725-32.
  • Gheorghiade M, Gottlieb SS, Udelson JE, Konstam MA, Czerwiec F, Ouyang J, et al. Vasopressin v(2) receptor blockade with tolvaptan versus fluid restriction in the treatment of hyponatremia. Am J Cardiol. 2006;97(7):1064-7.

Effectiveness of Tolvaptan Treatment in Hyponatremic Patients

Year 2020, Volume: 2 Issue: 2, 43 - 47, 29.04.2020
https://doi.org/10.46310/tjim.706226

Abstract

Objective: Non-peptide vasopressin receptor antagonists (vaptans) are effective at increasing sodium in euvolemic and hypervolemic states and appear safe. We aimed to evaluate the efficacy of tolvaptan in euvolemic or hypervolemic hyponatremic patients.
Methods: The study included 9 hyponatremic (serum sodium level <125 mmol/L) patients. Serum potassium levels of all patients were normal and there was no acid-base disturbance. Patients with hypovolemic status and hepatic dysfunction were excluded from the study. Clinical and laboratory data of patients were obtained before and after tolvaptan (7.5 mg/day) treatment.
Results: The median age of patients (6 females, 3 males) was 66.3 years (range, 56-82). The mean sodium levels before tolvaptan treatment were 120.5 mEq/L (SD 2.2, range, 116-124). The mean sodium levels increased significantly to 132.6±4.0 mEq/L (range, 125-140) after tolvaptan treatment at 2.7±1.3 days (range, 2-6) (p<0.001). Hyponatremia did not recur after tolvaptan treatment. We did not observe serious adverse event related with tolvaptan treatment.
Conclusion: Hyponatremia was a common problem, and tolvaptan can treat hyponatremia effectively and safely in patients with euvolemic or hypervolemic hyponatremia.

References

  • Verbalis JG. Hyponatremia: endocrinologic causes and consequences of therapy. Trends Endocrinol Metab. 1992;3(1):1-7.
  • Park GH, Lee CM, Song JW, Jung MC, Kim JK, Song YR, et al. Comparison of tolvaptan treatment between patients with the SIADH and congestive heart failure: a single-center experience. Korean J Intern Med. 2018;33(3):561-7.
  • Urso C, Brucculeri S, Caimi G. Employment of vasopressin receptor antagonists in management of hyponatraemia and volume overload in some clinical conditions. J Clin Pharm Ther. 2015;40(4):376-85.
  • Lilly LS, Dzau VJ, Williams GH, Rydstedt L, Hollenberg NK. Hyponatremia in congestive heart failure: implications for neurohumoral activation and responses to orthostasis. J Clin Endocrinol Metab. 1984;59(5):924-30.
  • Gralla RJ, Ahmad F, Blais JD, Chiodo J 3rd, Zhou W, Glaser LA, et al. Tolvaptan use in cancer patients with hyponatremia due to the syndrome of inappropriate antidiuretic hormone: a post hoc analysis of the SALT-1 and SALT-2 trials. Cancer Med. 2017;6(4):723-9.
  • Nemerovski C, Hutchinson DJ. Treatment of hypervolemic or euvolemic hyponatremia associated with heart failure, cirrhosis, or the syndrome of inappropriate antidiuretic hormone with tolvaptan: a clinical review. Clin Ther. 2010;32(6):1015-32.
  • Nielsen S, Kwon TH, Christensen BM, Promeneur D, Frøkiaer J, Marples D. Physiology and pathophysiology of renal aquaporins. J Am Soc Nephrol. 1999;10(3):647-63.
  • Schrier RW, Sharma S, Shchekochikhin D. Hyponatraemia: more than just a marker of disease severity? Nat Rev Nephrol. 2013;9(1):37-50.
  • Miyazaki T, Fujiki H, Yamamura Y, Nakamura S, Mori T. Tolvaptan, an orally active vasopressin V(2)-receptor antagonist - pharmacology and clinical trials. Cardiovasc Drug Rev. 2007;25(1):1-13.
  • Costello-Boerrigter LC, Smith WB, Boerrigter G, Ouyang J, Zimmer CA, Orlandi C, et al. Vasopressin-2-receptor antagonism augments water excretion without changes in renal hemodynamics or sodium and potassium excretion in human heart failure. Am J Physiol Renal Physiol. 2006;290(2):F273-8.
  • Kinugawa K, Sato N, Inomata T. Effects of Tolvaptan on Volume Overload in Patients with Heart Failure. Int Heart J. 2018;59(6):1368-77.
  • Gheorghiade M, Niazi I, Ouyang J, Czerwiec F, Kambayashi J, Zampino M, et al. Vasopressin V2-receptor blockade with tolvaptan in patients with chronic heart failure: results from a double-blind, randomized trial. Circulation. 2003;107(21):2690-6.
  • Dasta JF, Sundar S, Chase S, Lingohr-Smith M, Lin J. Economic impact of tolvaptan treatment vs. fluid restriction based on real-world data among hospitalized patients with heart failure and hyponatremia. Hosp Pract. 2018;46(4):197-202.
  • Alskaf E, Tridente A, Al-Mohammad A. Tolvaptan for Heart Failure, Systematic Review and Meta Analysis of Trials. J Cardiovasc Pharmacol. 2016;68(3):196-203.
  • Gheorghiade M, Konstam MA, Burnett JC Jr, Grinfeld L, Maggioni AP, Swedberg K, et al. Short-term clinical effects of tolvaptan, an oral vasopressin antagonist, in patients hospitalized for heart failure: the EVEREST Clinical Status Trials. JAMA. 2007;297(12):1332-43.
  • Matsue Y, Suzuki M, Seya M, Iwatsuka R, Mizukami A, Nagahori W, et al. Tolvaptan reduces the risk of worsening renal function in patients with acute decompensated heart failure in high-risk population. J Cardiol. 2013;61(2):169-74.
  • Matsue Y, Suzuki M, Nagahori W, Yoshida K, Onishi Y, Satoh Y, et al. Clinical effectiveness of tolvaptan in patients with acute decompensated heart failure and renal failure: design and rationale of the AQUAMARINE study. Cardiovasc Drugs Ther. 2014;28(1):73-7.
  • Schrier RW, Gross P, Gheorghiade M, Berl T, Verbalis JG, Czerwiec FS, et al. Tolvaptan, a selective oral vasopressin V2-receptor antagonist, for hyponatremia. N Engl J Med. 2006;355(20):2099-112.
  • Verbalis JG, Adler S, Schrier RW, Berl T, Zhao Q, Czerwiec FS; SALT Investigators. Efficacy and safety of oral tolvaptan therapy in patients with the syndrome of inappropriate antidiuretic hormone secretion. Eur J Endocrinol. 2011;164(5):725-32.
  • Gheorghiade M, Gottlieb SS, Udelson JE, Konstam MA, Czerwiec F, Ouyang J, et al. Vasopressin v(2) receptor blockade with tolvaptan versus fluid restriction in the treatment of hyponatremia. Am J Cardiol. 2006;97(7):1064-7.
There are 20 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Original Articles
Authors

Emel Isıktas Sayılar 0000-0002-8824-6560

Alparslan Ersoy 0000-0002-0710-0923

Yavuz Ayar 0000-0003-4607-9220

Mehmet Fethullah Aydın 0000-0002-5665-7402

Mahmut Yavuz 0000-0001-6755-6386

Publication Date April 29, 2020
Submission Date March 19, 2020
Acceptance Date April 24, 2020
Published in Issue Year 2020 Volume: 2 Issue: 2

Cite

EndNote Isıktas Sayılar E, Ersoy A, Ayar Y, Aydın MF, Yavuz M (April 1, 2020) Effectiveness of Tolvaptan Treatment in Hyponatremic Patients. Turkish Journal of Internal Medicine 2 2 43–47.

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