title: Long-Term Vaptan Treatment of Idiopathic SIADH in an Octogenarian.
abstract: Hyponatremia is the most common and by far underestimated electrolyte disorder in clinical practice. Especially in elderly patients, treatment of symptomatic hyponatremia is challenging. Herein we describe the case of an octogenarian with recurrent symptomatic hyponatremia due to idiopathic syndrome of inappropriate antidiuretic hormone release (SIADH). Fluid restriction was insufficient to prevent repeated episodes of hyponatremia complicated by falls and coma. After introduction of a low-dose therapy with tolvaptan, serum sodium levels as well as the clinical condition were stable under vaptan therapy, without any relapse for more than six years now. This case demonstrates that long-term tolvaptan treatment for hyponatremia caused by SIADH is safe and well tolerated, even in the elderly.
authors.affiliation: Medical Clinic III, Department of Nephrology, University Hospital Frankfurt, Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany. stefan.buettner@kgu.de.
authors.forename: Stefan
authors.initials: S
authors.lastname: Büttner
authors.affiliation: Nephrologisches Zentrum Sauerland, Dialyse und Praxis Arnsberg-Hüsten, 59759 Arnsberg, Germany. bachmann@dialyse-arnsberg.de.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Bachmann
authors.affiliation: Medical Clinic III, Department of Nephrology, University Hospital Frankfurt, Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany. helmut.geiger@kgu.de.
authors.forename: Helmut
authors.initials: H
authors.lastname: Geiger
authors.affiliation: Medical Clinic III, Department of Nephrology, University Hospital Frankfurt, Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany. obermueller@em.uni-frankfurt.de.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Obermüller
keywords: SIADH; elderly; hyponatremia; tolvaptan