| Revue: | Annals of hepatology |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000406055 |
| ISSN: | 1665-2681 |
| Autores: | Ji-Dong Jia1 Wen Xie1 Hui-Guo Ding1 Hua Mao2 Hui Guo3 Yonggang Li4 Xiaojin Wang5 Jie-Fei Wang6 Wei Lu7 Cheng-Zhong Li8 Yimin Mao9 Gui-Qiang Wang10 Yue-qiu Gao11 Bangmao Wang12 Qin Zhang9 Yan Ge13 Vincent Wai-Sun Wong14 |
| Instituciones: | 1Capital Medical University, Beijing. China 2Southern Medical University, Guangzhou, Guangdong. China 3Tianjin University of Traditional Chinese Medicine, First Teaching Hospital, Tianjin. China 4302 Military Hospital of People’s Liberation Army, Department of Integrative Medical Center, Beijing. China 5Hospital 85 People’s Liberation Army of China, Shanghai. China 6Fudan University, Shanghai Public Health Clinical Center, Shanghai. China 7Tianjin Second People-s Hospital, Tianjin. China 8The Second Military Medical University, Shanghai Hospital, Shanghai. China 9Jiaotong University, School of Medicine, Shanghai. China 10Peking University, First Hospital, Beijing. China 11Shanghai University of Traditional Chinese Medicine, Shuguang Hospital, Shanghai. China 12Tianjin Medical University General Hospital, Department of Gastroenterology, Tianjin. China 13Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, Guangdong. China 14The Chinese University of Hong Kong, Department of Medicine and Therapeutics, Hong Kong. China |
| Año: | 2017 |
| Periodo: | Ene-Feb |
| Volumen: | 16 |
| Número: | 1 |
| Paginación: | 123-132 |
| País: | México |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Enfoque: | Experimental, caso clínico |
| Resumen en inglés | 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 |
| Disciplinas: | Medicina |
| Palabras clave: | Gastroenterología, Terapéutica y rehabilitación, Cirrosis, Hiponatremia, Vasopresina, Tolvaptan, Hormona antidiurética, Sodio, Espironolactona, Insuficiencia hepática |
| Keyword: | Medicine, Gastroenterology, Therapeutics and rehabilitation, Cirrhosis, Hyponatremia, Vasopressin, Tolvaptan, Antidiuretic hormone, Sodium, Spironolactone, Liver failure |
| Texte intégral: | Texto completo (Ver HTML) |
