Trial reportJournal of hepatology2015
Correction of hyponatraemia improves cognition, quality of life, and brain oedema in cirrhosis.
Trial report in Journal of hepatology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 78 citations in OpenAlex.
- Impact of Vaptans on Clinical Outcomes in Cirrhosis Patients: A Meta-Analysis of Randomized Controlled Trials.Frontiers in pharmacology · 2019Pooled it
- The RIVET RCT: Rifamycin SV MMX improves muscle mass, physical function, and ammonia in cirrhosis and minimal encephalopathy.Hepatology communications · 2024Trial
- Tolvaptan treatment improves survival of cirrhotic patients with ascites and hyponatremia.BMC gastroenterology · 2018Trial
- KASL clinical practice guidelines for liver cirrhosis: Ascites and related complications 2026.Clinical and molecular hepatology · 2026Article
- Advances in understanding, diagnosing, and treating hepatic encephalopathy: from epidemiology to emerging therapies.Naunyn-Schmiedeberg's archives of pharmacology · 2026Review
- Hyponatraemia in ageing.Nature reviews. Endocrinology · 2025Review
- Ribosomal s6 kinase is a mediator of aquaporin-2 S256 phosphorylation and membrane accumulation after EGFR inhibition with erlotinib.American journal of physiology. Renal physiology · 2025Article
- The social and psychological impact of hepatic encephalopathy.Metabolic brain disease · 2024Review
- Serum sodium, cognition and incident dementia in the general population.Age and ageing · 2023Article
- Effects of Short-Term Human Albumin Infusion for the Prevention and Treatment of Hyponatremia in Patients with Liver Cirrhosis.Journal of clinical medicine · 2022Article
- Approach to the Patient: Hyponatremia and the Syndrome of Inappropriate Antidiuresis (SIAD).The Journal of clinical endocrinology and metabolism · 2022Review
- Prevalence and clinical significance of serum sodium variability in patients with acute-on-chronic liver diseases: a prospective multicenter study in China.Hepatology international · 2022Article
- Update on blood-based biomarkers for chronic liver diseases prognosis: Literature review and institutional experience.JGH open : an open access journal of gastroenterology and hepatology · 2021Review
- Hyponatremia Intervention Trial (HIT): Study Protocol of a Randomized, Controlled, Parallel-Group Trial With Blinded Outcome Assessment.Frontiers in medicine · 2021Article
- Natremia and liver transplantation: The right amount of salt for a good recipe.World journal of hepatology · 2020Review
- Tolvaptan Efficiently Reduces Intracellular Fluid: Working Toward a Potential Treatment Option for Cellular Edema.Internal medicine (Tokyo, Japan) · 2019Observational
- Understanding the impact of neurologic complications in patients with cirrhosis.SAGE open medicine · 2019Review
- Evidence for Effective Multiple KFrontiers in pharmacology · 2019Article
- Approach and management of dysnatremias in cirrhosis.Hepatology international · 2018Review
- Taurine supplementation abates cirrhosis-associated locomotor dysfunction.Clinical and experimental hepatology · 2018Article
Corrections and comments
- Commented on by
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsHyponatraemia in cirrhosis is associated with impaired cognition and poor health-related quality of life (HRQOL). However, the benefit of hyponatraemia correction is unclear. The aim of this study was to evaluate the effect of tolvaptan on serum sodium (Na), cognition, HRQOL, companion burden, and brain MRI (volumetrics, spectroscopy, and diffusion tensor imaging) in cirrhotics with hyponatraemia.
methodsCirrhotics with Na <130 mEq/L were included for a four-week trial. At screening, patients underwent cognitive and HRQOL testing, serum/urine chemistries and companion burden assessment. Patients then underwent fluid restriction and diuretic withdrawal for two weeks after which cognitive tests were repeated. If Na was still <130 mEq/L, brain magnetic resonance imaging (MRI) was performed and tolvaptan was initiated for 14 days with frequent clinical/laboratory monitoring. After 14 days of tolvaptan, all tests were repeated. Comparisons were made between screen, pre-and post-drug periods Na, urine/serum laboratories, cognition, HRQOL and companion burden.
results24 cirrhotics were enrolled; seven normalized Na without tolvaptan with improvement in cognition. The remaining 17 received tolvaptan of which 14 completed the study over 13 ± 2 days (age 58 ± 6 years, MELD 17, 55% HCV, median 26 mg/day of tolvaptan). Serum Na and urine free water clearance increased with tolvaptan without changes in mental status or liver function. Cognitive function, HRQOL and companion burden only improved in these 14 patients after tolvaptan, along with reduced total brain and white matter volume, increase in choline on magnetic resonance spectroscopy, and reduced cytotoxic oedema.
conclusionsShort-term tolvaptan therapy is well tolerated in cirrhosis. Hyponatraemia correction is associated with cognitive, HRQOL, brain MRI and companion burden improvement.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.