Role of vaptans in the management of hyponatremia

Journal Article

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. © 2013 National Kidney Foundation, Inc.

Full Text

Duke Authors

Cited Authors

  • Lehrich, RW; Ortiz-Melo, DI; Patel, MB; Greenberg, A

Published Date

  • 2013

Published In

Volume / Issue

  • 62 / 2

Start / End Page

  • 364 - 376

International Standard Serial Number (ISSN)

  • 0272-6386

Digital Object Identifier (DOI)

  • 10.1053/j.ajkd.2013.01.034