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Clinical utility of tolvaptan in the management of hyponatremia in heart failure patients.

Nodari S, Jao GT, Chiong JR - Int J Nephrol Renovasc Dis (2010)

Bottom Line: It is caused by deregulation of arginine vasopressin (AVP) homeostasis associated with water retention in hypervolemic or in euvolemic states.While hypervolemic hypotonic hyponatremia is also seen in advanced liver cirrhosis, renal failure, and nephrotic syndrome, the bulk of evidence associating this electrolyte disorder to increasing morbidity and mortality can be found in the HF literature.Conventional therapeutic approaches, ie, restriction of fluid intake, saline and diuretics, can be effective, but often the results are unpredictable.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, University of Brescia, Brescia, Italy.

No MeSH data available.


Related in: MedlinePlus

Changes in serum sodium level (EVEREST trial).
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f2-ijnrd-3-051: Changes in serum sodium level (EVEREST trial).

Mentions: Among patients with baseline serum sodium levels <134 mEq/L (8% of total), the mean serum sodium concentration significantly increased in the tolvaptan group compared to placebo group. This effect was observed since day 1 and persisted throughout the follow-up period (Figure 2). In spite of the significant improvement in short-term clinical status outcomes and in increasing sodium serum concentration among hyponatremic patients, tolvaptan administration in addition to standard therapy did not affect long term mortality or heart failure-related morbidity.32 However dose titration of treatment considering clinical status (entity of dyspnea, peripheral edema, pulmonary congestion, body weight) and a dose adjustment based on clinical response could lead to better results in term of symptoms and outcomes.


Clinical utility of tolvaptan in the management of hyponatremia in heart failure patients.

Nodari S, Jao GT, Chiong JR - Int J Nephrol Renovasc Dis (2010)

Changes in serum sodium level (EVEREST trial).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3108784&req=5

f2-ijnrd-3-051: Changes in serum sodium level (EVEREST trial).
Mentions: Among patients with baseline serum sodium levels <134 mEq/L (8% of total), the mean serum sodium concentration significantly increased in the tolvaptan group compared to placebo group. This effect was observed since day 1 and persisted throughout the follow-up period (Figure 2). In spite of the significant improvement in short-term clinical status outcomes and in increasing sodium serum concentration among hyponatremic patients, tolvaptan administration in addition to standard therapy did not affect long term mortality or heart failure-related morbidity.32 However dose titration of treatment considering clinical status (entity of dyspnea, peripheral edema, pulmonary congestion, body weight) and a dose adjustment based on clinical response could lead to better results in term of symptoms and outcomes.

Bottom Line: It is caused by deregulation of arginine vasopressin (AVP) homeostasis associated with water retention in hypervolemic or in euvolemic states.While hypervolemic hypotonic hyponatremia is also seen in advanced liver cirrhosis, renal failure, and nephrotic syndrome, the bulk of evidence associating this electrolyte disorder to increasing morbidity and mortality can be found in the HF literature.Conventional therapeutic approaches, ie, restriction of fluid intake, saline and diuretics, can be effective, but often the results are unpredictable.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, University of Brescia, Brescia, Italy.

No MeSH data available.


Related in: MedlinePlus