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Role of vaptans in the management of hyponatremia.

Publication ,  Journal Article
Lehrich, RW; Ortiz-Melo, DI; Patel, MB; Greenberg, A
Published in: Am J Kidney Dis
August 2013

Hyponatremia, the most commonly encountered electrolyte abnormality, affects as many as 30% of hospitalized patients. It is a powerful predictor of poor outcomes, especially in patients with congestive heart failure or cirrhosis. The failure to excrete electrolyte-free water that results from persistent secretion of antidiuretic hormone despite low serum osmolality usually underlies the development of hyponatremia. Treatment depends on several factors, including the cause, overall volume status of the patient, severity of hyponatremic symptoms, and duration of hyponatremia at presentation. This review focuses on the role of the vasopressin receptor antagonists, or vaptans, in the treatment of hyponatremia. These recently introduced agents have the unique ability to induce an aquaresis, the excretion of electrolyte-free water without accompanying solutes. After a brief historical perspective and discussion of pharmacologic characteristics of vaptans, we review the accumulated experience with vaptans for the treatment of hyponatremia. Vaptans have been shown to increase serum sodium concentrations in patients with euvolemic or hypervolemic hyponatremia in a reproducible manner, but their safe use requires full understanding of their indications and contraindications.

Duke Scholars

Published In

Am J Kidney Dis

DOI

EISSN

1523-6838

Publication Date

August 2013

Volume

62

Issue

2

Start / End Page

364 / 376

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Tolvaptan
  • Pyrroles
  • Middle Aged
  • Male
  • Hyponatremia
  • Humans
  • Benzazepines
  • Benzamides
  • Antidiuretic Hormone Receptor Antagonists
 

Citation

APA
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MLA
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Lehrich, R. W., Ortiz-Melo, D. I., Patel, M. B., & Greenberg, A. (2013). Role of vaptans in the management of hyponatremia. Am J Kidney Dis, 62(2), 364–376. https://doi.org/10.1053/j.ajkd.2013.01.034
Lehrich, Ruediger W., David I. Ortiz-Melo, Mehul B. Patel, and Arthur Greenberg. “Role of vaptans in the management of hyponatremia.Am J Kidney Dis 62, no. 2 (August 2013): 364–76. https://doi.org/10.1053/j.ajkd.2013.01.034.
Lehrich RW, Ortiz-Melo DI, Patel MB, Greenberg A. Role of vaptans in the management of hyponatremia. Am J Kidney Dis. 2013 Aug;62(2):364–76.
Lehrich, Ruediger W., et al. “Role of vaptans in the management of hyponatremia.Am J Kidney Dis, vol. 62, no. 2, Aug. 2013, pp. 364–76. Pubmed, doi:10.1053/j.ajkd.2013.01.034.
Lehrich RW, Ortiz-Melo DI, Patel MB, Greenberg A. Role of vaptans in the management of hyponatremia. Am J Kidney Dis. 2013 Aug;62(2):364–376.
Journal cover image

Published In

Am J Kidney Dis

DOI

EISSN

1523-6838

Publication Date

August 2013

Volume

62

Issue

2

Start / End Page

364 / 376

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Tolvaptan
  • Pyrroles
  • Middle Aged
  • Male
  • Hyponatremia
  • Humans
  • Benzazepines
  • Benzamides
  • Antidiuretic Hormone Receptor Antagonists