When is it appropriate to use vasopressin receptor antagonists?

Journal Article (Journal Article)

Hyponatremia is a common and challenging disorder. The mainstays of treatment until recently were water restriction and hypertonic saline. The first nonpeptide vasopressin receptor antagonist (VRA) is now approved by the US Food and Drug Administration for use in patients with euvolemic and hypervolemic hyponatremia. VRA induce urinary dilution with an aquaresis that leads to an increase in serum sodium concentration. In patients with heart failure, VRA modestly improve congestive symptoms but have no effect on short- or long-term mortality. Long-term effects have not been extensively studied, but serious adverse effects of VRA are rare, and the rate of rise in serum sodium that they produce seems unlikely to lead to osmotic demyelination. Beneficial effects beyond changing serum tonicity and alternative uses, such as in polycystic kidney disease, need further exploration. This commentary discusses the current and potential indications for use of VRA.

Full Text

Duke Authors

Cited Authors

  • Lehrich, RW; Greenberg, A

Published Date

  • June 2008

Published In

Volume / Issue

  • 19 / 6

Start / End Page

  • 1054 - 1058

PubMed ID

  • 18337478

Pubmed Central ID

  • 18337478

Electronic International Standard Serial Number (EISSN)

  • 1533-3450

Digital Object Identifier (DOI)

  • 10.1681/ASN.2008010089


  • eng

Conference Location

  • United States