title: Vasopressin receptor antagonists: Characteristics and clinical role.
abstract: Hyponatremia, the most common electrolyte disorder in hospitalized patients is associated with increased risk of mortality even when mild and apparently asymptomatic. Likewise morbidity manifested as attention deficits, gait disturbances, falls, fractures, and osteoporosis is more prevalent in hyponatremic subjects. Hyponatremia also generates a significant financial burden. Therefore, it is important to explore approaches that effectively and safely treat hyponatremia. Currently available strategies are physiologically sound and affordable but lack evidence from clinical trials and are limited by variable efficacy, slow response, and/or poor compliance. The recent emergence of vasopressin receptor antagonists provides a class of drugs that target the primary pathophysiological mechanism, namely vasopressin mediated impairment of free water excretion. This review summarizes the historical development, pharmacology, clinical trials supporting efficacy and safety, shortcomings, as well as practical suggestions for the use of vasopressin receptor antagonists.
authors.affiliation: Renal-Electrolyte Division, University of Pittsburgh, A915 Scaife Hall, 3550 Terrace St, Pittsburgh, PA 15261, USA. Electronic address: rondonberriosh@upmc.edu.
authors.forename: Helbert
authors.initials: H
authors.lastname: Rondon-Berrios
authors.affiliation: Division of Nephrology and Hypertension, University of Colorado, Aurora, CO, USA. Electronic address: Tomas.Berl@ucdenver.edu.
authors.forename: Tomas
authors.initials: T
authors.lastname: Berl
mesh_terms: D065092:Antidiuretic Hormone Receptor Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D007010:Hyponatremia / Q000188:drug therapy*; D014882:Water-Electrolyte Balance
chemical_list: D065092:Antidiuretic Hormone Receptor Antagonists
keywords: antidiuretic hormone receptor antagonists; hyponatremia; vasopressin