ArticleAnnals of intensive care2016
Tolvaptan for hyponatremia with preserved sodium pool in critically ill patients.
Article in Annals of intensive care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- Criteria for Hyponatremic Overcorrection: Systematic Review and Cohort Study of Emergently Ill Patients.Journal of general internal medicine · 2020Pooled it
- A new frontier in edema management: the potential of tolvaptan for refractory edema with hyponatremia in pediatric nephrotic syndrome.Clinical and experimental nephrology · 2026Article
- Tolvaptan for the treatment of the syndrome of inappropriate antidiuresis (SIAD).Therapeutic advances in endocrinology and metabolism · 2023Review
- Association between early elevated phosphate and mortality among critically ill elderly patients: a retrospective cohort study.BMC geriatrics · 2022Article
- The role of tolvaptan in managing hyponatremia in small cell lung cancer patients with SIADH: a retrospective study of 23 cases.Translational cancer research · 2021Article
- Vasopressin antagonist efficacy and safety in volume-overloaded critically ill patients: a new therapeutic alternative.European journal of hospital pharmacy : science and practice · 2020Observational
- Risk factors for sodium overcorrection in non-hypovolemic hyponatremia patients treated with tolvaptan.European journal of clinical pharmacology · 2020Article
- Rapidity of Correction of Hyponatremia Due to Syndrome of Inappropriate Secretion of Antidiuretic Hormone Following Tolvaptan.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2018Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHyponatremia is the most common electrolyte disturbance in hospitalized patients, and it represents a well-established risk factor for ICU/hospital mortality. The majority of hyponatremic states are associated with elevated arginine vasopressin levels and a preserved sodium pool. Conventional treatment is either not pathophysiologically oriented or of limited effectiveness. The aim of the present study is to investigate the use of enteral Tolvaptan in critically ill hyponatremic patients.
methodsThis is a retrospective observational study in a general ICU. Patients with preserved sodium pool hyponatremia refractory to conventional therapy were enrolled. The hemodynamic, renal, and hepatic functions, together with sodium and water balance as close as possible to the drug administration and up to 72 h thereafter, were analyzed. The main outcome was a serum sodium increase of ≥ 4 mmol/L in 24 h; secondary endpoints were the ability to maintain serum sodium at 24 and 72 h, a decrease in urine sodium concentration and an increase in sodium-free diuresis.
results38 patients were enrolled. The average dose of enteral Tolvaptan was 7.5 mg. 31 patients (81.6 %) increased their serum sodium >4 mmol/l/24 h; the average increase was 6.7 ± 3.4 mmol/l during the first 24 h (p < 0.001 vs baseline), and this was sustained at 72 h. No adverse effects were reported. Plasma sodium (R = -0.622, p < 0.001), urine sodium (R = -0.345, p < 0.001), central venous oxygen saturation (R = 0.401, p = 0.013), and BUN (R = -0.416, p = 0.031) before Tolvaptan were all significantly correlated with the absolute increase in serum sodium after the administration.
conclusionsEnteral administration of Tolvaptan seems effective in the treatment of hyponatremia with preserved sodium pool in critically ill patients. Even if the study was underpowered to detect significant side effects or complications of unwarranted fast corrections of hyponatremia, we report no complications.
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