ArticleKidney medicine
Equivalent Efficacy and Decreased Rate of Overcorrection in Patients With Syndrome of Inappropriate Secretion of Antidiuretic Hormone Given Very Low-Dose Tolvaptan.
Article in Kidney medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 13 papers.
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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.
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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
13 citing papers in PubMed, 27 citations in OpenAlex.
- Efficacy of Low-Dose Tolvaptan for Treatment of Profound Hyponatremia in Syndrome of Inappropriate Antidiuresis (SIAD): The EFFLUX-FLUID TRIAL.Kidney medicine · 2026Article
- [67/m with impaired consciousness secondary to bronchial carcinoma : Preparation for the medical specialist examination: part 20].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Article
- Tolvaptan versus other interventions for hyponatraemia in people with cirrhosis.The Cochrane database of systematic reviews · 2025Article
- Syndrome of Inappropriate Antidiuresis.Journal of the American Society of Nephrology : JASN · 2025Review
- Clinical factors associated with hyponatremia correction during treatment with oral urea.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025Article
- Long-term low-dose tolvaptan efficacy and safety in SIADH.Endocrine · 2023Article
- [Hyponatremia : Etiology, diagnosis and acute therapy].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2023Article
- Safety and Efficacy of Vaptans in the Treatment of Hyponatremia from Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH): A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2023Review
- Review
- Tolvaptan for the treatment of the syndrome of inappropriate antidiuresis (SIAD).Therapeutic advances in endocrinology and metabolism · 2023Review
- Approach to the Patient: Hyponatremia and the Syndrome of Inappropriate Antidiuresis (SIAD).The Journal of clinical endocrinology and metabolism · 2022Review
- Article
- The management of acute and chronic hyponatraemia.Therapeutic advances in endocrinology and metabolism · 2022Review
Corrections and comments
- Erratum issued
Authors and funding
11 authors at 5 institutions in 1 country.
Funding
Abstract
RATIONALE &
objectiveEuvolemic hyponatremia often occurs due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Vasopressin 2 receptor antagonists may be used to treat SIADH. Several of the major trials used 15 mg of tolvaptan as the lowest effective dose in euvolemic and hypervolemic hyponatremia. However, a recent observational study suggested an elevated risk for serum sodium level overcorrection with 15 mg of tolvaptan in patients with SIADH. STUDY
designA retrospective chart review study comparing outcomes in patients with SIADH treated with 15 versus 7.5 mg of tolvaptan. SETTINGS &
participantsPatients with SIADH who were treated with a very low dose of tolvaptan (7.5 mg) at a single center compared with patients using a 15-mg dose from patient-level data from the observational study described previously. PREDICTORS: Tolvaptan dose of 7.5 versus 15 mg daily. OUTCOMES: Appropriate response to tolvaptan, defined as an initial increase in serum sodium level > 3 mEq/L, and overcorrection of serum sodium level (>8 mEq/L per day, and >10 mEq/L per day in sensitivity analyses). ANALYTICAL APPROACH: Descriptive study with additional outcomes compared using
resultsAmong 18 patients receiving 7.5 mg of tolvaptan, the mean rate of correction was 5.6 ± 3.1 mEq/L per day and 2 (11.1%) patients corrected their serum sodium levels by >8 mEq/L per day, with 1 of these increasing by >12 mEq/L per day. Of those receiving tolvaptan 7.5 mg, 14 had efficacy, with increases ≥ 3 mEq/L; similar results were seen with the 15-mg dose (21 of 28). There was a statistically significant higher chance of overcorrection with the use of 15 versus 7.5 mg of tolvaptan (11 of 28 vs 2 of 18; LIMITATIONS: Small sample size, retrospective, and nonrandomized.
conclusionsTolvaptan, 7.5 mg, daily corrects hyponatremia with similar efficacy and less risk for overcorrection in patients with SIADH versus 15 mg of tolvaptan.
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