title: Limited Efficacy of Tolvaptan in Patients with Cirrhosis and Severe Hyponatremia: Real-Life Experience.
abstract: BACKGROUND
  Vaptans, vasopressin selective V2-receptor antagonists, represent the first pharmacologic approach to the treatment of hypervolemic hyponatremia in cirrhosis. However, information on the use of vaptans for patients with cirrhosis and hyponatremia in a real-life scenario is limited. Therefore, this study evaluated the effect of tolvaptan on serum sodium in patients with cirrhosis and severe hypervolemic hyponatremia.
  
  
  METHODS
  Nine patients with cirrhosis and serum sodium ≤125 mEq/L were included.
  
  
  RESULTS
  Only 2 of the 9 patients (22%) gained an increase in serum sodium >130 mEq/L that persisted throughout treatment. In the remaining patients, serum sodium did not change or increased during the first days but decreased thereafter despite continuation of treatment. Only 1 patient developed hyperkalemia as a side effect.
  
  
  CONCLUSIONS
  The efficacy of tolvaptan in patients with cirrhosis and severe hypervolemic hyponatremia seems to be limited.
authors.affiliation: Liver Unit, Hospital Clínic, University of Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain; Instituto Reina Sofía de Investigación Nefrológica, Spain.
authors.forename: Elisa
authors.initials: E
authors.lastname: Pose
authors.affiliation: Liver Unit, Hospital Clínic, University of Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain; Instituto Reina Sofía de Investigación Nefrológica, Spain. Electronic address: esola@clinic.ub.es.
authors.forename: Elsa
authors.initials: E
authors.lastname: Solà
authors.affiliation: Unit of Hepatic Emergencies and Liver Transplantation, Department of Medicine, University of Padova, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Piano
authors.affiliation: Unit of Hepatic Emergencies and Liver Transplantation, Department of Medicine, University of Padova, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Gola
authors.affiliation: Liver Unit, Hospital Clínic, University of Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain; Instituto Reina Sofía de Investigación Nefrológica, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Graupera
authors.affiliation: Liver Unit, Hospital Clínic, University of Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain; Instituto Reina Sofía de Investigación Nefrológica, Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: Guevara
authors.affiliation: Institute of Digestive Diseases and Metabolism, Hospital Clinic, University of Barcelona, Spain.
authors.forename: Andrés
authors.initials: A
authors.lastname: Cárdenas
authors.affiliation: Unit of Hepatic Emergencies and Liver Transplantation, Department of Medicine, University of Padova, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Angeli
authors.affiliation: Liver Unit, Hospital Clínic, University of Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain; Instituto Reina Sofía de Investigación Nefrológica, Spain.
authors.forename: Pere
authors.initials: P
authors.lastname: Ginès
mesh_terms: D000368:Aged; D065092:Antidiuretic Hormone Receptor Antagonists / Q000627:therapeutic use*; D001552:Benzazepines / Q000627:therapeutic use*; D005260:Female; D051270:Headache Disorders, Primary / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017483:Receptors, Vasopressin; D012964:Sodium / Q000097:blood; D000077602:Tolvaptan; D016896:Treatment Outcome
chemical_list: D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines; D017483:Receptors, Vasopressin; D000077602:Tolvaptan; D012964:Sodium
keywords: Cirrhosis; Hypervolemic hyponatremia; Hyponatremia; Tolvaptan; Vasopressin