Observational studyWorld journal of gastroenterology2014
Clinical efficacy of tolvaptan for treatment of refractory ascites in liver cirrhosis patients.
Observational study in World journal of gastroenterology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Chinese guidelines on the management of ascites and its related complications in cirrhosis.Hepatology international · 2019Guideline
- Tolvaptan for hyponatremia in patients with cirrhosis: a post hoc subgroup analysis of a multicenter, randomized, double-blind, placebo-controlled trial.Hepatology international · 2026Trial
- Tolvaptan treatment improves survival of cirrhotic patients with ascites and hyponatremia.BMC gastroenterology · 2018Trial
- [Research progress of tolvaptan in the treatment of refractory ascites in cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025Review
- Chronic renal dysfunction in cirrhosis: A new frontier in hepatology.World journal of gastroenterology · 2021Article
- Current approaches to the management of patients with cirrhotic ascites.World journal of gastroenterology · 2019Review
- The first Chinese guidelines on the Management of Ascites and its Related Complications in Cirrhosis: a great goal for a great country.Hepatology international · 2019Article
- [Follow-up observation on short-term efficacy of low dose tolvaptan in the management of cirrhotic hyponatremia].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2019Article
- Impaired Renal Function May Not Negate the Efficacy of Tolvaptan in the Treatment of Cirrhotic Patients with Refractory Ascites.Clinical drug investigation · 2019Article
- Response criteria of tolvaptan for the treatment of hepatic edema.Journal of gastroenterology · 2018Article
- Management of refractory cirrhotic ascites: challenges and solutions.Hepatic medicine : evidence and research · 2018Review
- Article
- [Guidelines on the management of ascites and complications in cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2017Article
- Ascites, refractory ascites and hyponatremia in cirrhosis.Gastroenterology report · 2017Article
- [New therapeutic paradigm and concepts for patients with cirrhotic refractory ascites].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2017Article
- Usefulness of portal vein pressure for predicting the effects of tolvaptan in cirrhotic patients.World journal of gastroenterology · 2016Article
- Urinary excretion of the water channel aquaporin 2 correlated with the pharmacological effect of tolvaptan in cirrhotic patients with ascites.Journal of gastroenterology · 2016Article
- Do vasopressin V2 receptor antagonists benefit cirrhotics with refractory ascites?World journal of gastroenterology · 2015Review
- Predictive value of the efficacy of tolvaptan in liver cirrhosis patients using free water clearance.Biomedical reports · 2015Article
- Impact of hyponatremia on frequency of complications in patients with decompensated liver cirrhosis.Electronic physician · 2015Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo evaluate the efficacy and safety of tolvaptan to treat refractory ascites in decompensated liver cirrhosis patients with or without further complications, such as hepatorenal syndrome and/or hepatocellular carcinoma.
methodsThirty-nine patients (mean age 55 years, males: 32) with decompensated liver cirrhosis and refractory ascites were enrolled. All patients received a combination of tolvaptan (15 mg/d for 5-14 d) and diuretics (40-80 mg/d of furosemide and 80-160 mg/d of spironolactone). The etiology of cirrhosis included hepatitis B (69.2%), hepatitis C (7.7%) and alcohol-induced (23.1%). Changes in the urine excretion volume, abdominal circumference and edema were assessed. The serum sodium levels were also measured, and adverse events were recorded. A follow-up assessment was conducted 1 mo after treatment with tolvaptan.
resultsTolvaptan increased the mean urine excretion volume (1969.2 ± 355.55 mL vs 3410.3 ± 974.1 mL, P < 0.001), and 89.7% of patients showed improvements in their ascites, 46.2% of whom showed significant improvements. The overall efficacy of tolvaptan in all patients was 89.7%; the efficacies in patients with hepatocellular carcinoma and hepatorenal syndrome were 84.2% and 77.8%, respectively. The incidence of hyponatremia was 53.8%. In patients with hyponatremia, the serum sodium levels increased after tolvaptan treatment (from 128.1 ± 4.22 mEq/L vs 133.1 ± 3.8 mEq/L, P < 0.001). Only mild drug-related adverse events, including thirst and dry mouth, were observed.
conclusionTolvaptan is a promising aquaretic for the treatment of refractory ascites in patients with decompensated liver cirrhosis.
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