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Collections Vaptans, Acuaresis and Syndrom...

Vaptans, Acuaresis and Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)

https://read.qxmd.com/read/32801723/syndrome-of-inappropriate-antidiuretic-hormone-secretion-siadh-optimal-management
#21
REVIEW
Giulia Mentrasti, Laura Scortichini, Mariangela Torniai, Riccardo Giampieri, Francesca Morgese, Silvia Rinaldi, Rossana Berardi
Hyponatremia, defined as serum sodium concentration <135 mEq/l, is the most common electrolyte balance disorder in clinical practice. Many causes are listed, but syndrome of inappropriate antidiuretic hormone secretion (SIADH) is certainly the most relevant, mainly in oncological and hospitalized patients. In this review, the pathophysiological and clinical aspects are described in detail. Patients' extensive medical history and structured physical and biochemical tests are considered the milestones marking the way of the SIADH management as to provide early detection and proper correction...
2020: Therapeutics and Clinical Risk Management
https://read.qxmd.com/read/32645703/sglt-2-inhibitors-to-treat-hyponatremia-associated-with-siadh-a-novel-indication
#22
EDITORIAL
Pantelis Sarafidis, Charalampos Loutradis, Charles J Ferro, Alberto Ortiz
No abstract text is available yet for this article.
2020: American Journal of Nephrology
https://read.qxmd.com/read/32500625/tolvaptan-add-on-therapy-in-patients-with-acute-heart-failure-a-systematic-review-and-meta-analysis
#23
COMPARATIVE STUDY
Xiandu Luo, Qi Jin, Yanqing Wu
This study aimed to investigate the short-term efficacy and safety of tolvaptan as an add-on to traditional diuretics in patients with acute heart failure (AHF). The PubMed, EMBASE, Cochrane Library, and Web of Science databases were comprehensively searched for all randomized controlled trials (RCTs) that examined AHF patients treated with tolvaptan as a combination therapy with traditional diuretics published on or before December 2, 2019. Efficacy indicators such as improved dyspnea, reduced edema, and changes in urine output and body weight were evaluated...
June 2020: Pharmacology Research & Perspectives
https://read.qxmd.com/read/32232633/tolvaptan-therapy-to-treat-severe-hyponatremia-in-pediatric-nephrotic-syndrome
#24
JOURNAL ARTICLE
Jean-Daniel Delbet, Cyrielle Parmentier, Tim Ulinski
BACKGROUND: Tolvaptan is a selective oral vasopressin V2-receptor antagonist. Some data have implicated stimulation of arginine vasopressin (AVP) as an important factor in oedema formation in a rodent model of nephrotic syndrome (NS) and adult NS patients. We report case of pediatric NS with severe hyponatremia efficiently treated by tolvaptan. CASE/DIAGNOSIS - TREATMENT: A 22-month-old girl presented first with NS. She remained nephrotic after a 30-day course of oral steroids...
July 2020: Pediatric Nephrology
https://read.qxmd.com/read/32199708/efficacy-of-furosemide-oral-sodium-chloride-and-fluid-restriction-for-treatment-of-syndrome-of-inappropriate-antidiuresis-siad-an-open-label-randomized-controlled-study-the-effuse-fluid-trial
#25
RANDOMIZED CONTROLLED TRIAL
Pajaree Krisanapan, Surachet Vongsanim, Pathomporn Pin-On, Chidchanok Ruengorn, Kajohnsak Noppakun
RATIONALE & OBJECTIVE: First-line therapy for syndrome of inappropriate antidiuresis (SIAD) is fluid restriction. Additional treatment for patients who do not respond to fluid restriction are water restriction with furosemide or water restriction with furosemide and salt supplementation. However, the efficacy of these treatments has never been tested in a randomized controlled study. The objective of this study was to investigate whether, combined with fluid restriction, furosemide with or without sodium chloride (NaCl) supplementation was more effective than fluid restriction alone in the treatment of hyponatremia in SIAD...
August 2020: American Journal of Kidney Diseases
https://read.qxmd.com/read/31988816/long-term-use-of-demeclocycline-for-the-treatment-of-chronic-hyponatremia
#26
Amardeep Singh, Bhagwan Dass, Abutaleb Ejaz, Atul Bali
Syndrome of inappropriate antidiuretic hormone secretion may be a frequent accompaniment of aging without an obvious central nervous system or pulmonary disorder, tumor, or drugs as the confounding factor. Treatment is often warranted due to complex symptomatology that is often associated with unfavorable clinical outcomes. Although V2 -receptor antagonists are effective in increasing serum sodium, their side-effect profile and cost may be a barrier to its use. We report a patient with symptomatic, severe, chronic hyponatremia requiring multiple hospitalizations, who was successfully maintained on long-term demeclocycline therapy...
December 18, 2019: Curēus
https://read.qxmd.com/read/31980355/advent-of-new-perioperative-care-for-fluid-management-after-cardiovascular-surgery-a-review-of-current-evidence
#27
REVIEW
Hiroyuki Nishi
Fluid management with diuretics is a key factor for postoperative management following cardiovascular surgery, and it is common to administer intermittent doses of diuretics and fluids in the early postoperative stage as primary therapy. Loop diuretics are usually given as the first option, followed by an aldosterone blocker, mannitol, and human atrial natriuretic peptide (hANP) or recombinant human B-type natriuretic peptide infusion. Although the effects of tolvaptan, a new type of diuretic with an aquaretic effect to increase urine volume without increasing electrolyte excretion into urine by blocking the vasopressin V2 receptor, on congestive heart failure are well known, it has not been established whether advantages may also be recognized in the volume overload in early postoperative stage after cardiac surgery...
June 2020: Journal of Cardiology
https://read.qxmd.com/read/31682170/aquaporins-in-the-kidney-physiology-and-pathophysiology
#28
REVIEW
Wen Su, Rong Cao, Xiao-Yan Zhang, Youfei Guan
The kidney is the central organ involved in maintaining water and sodium balance. In human kidneys, nine aquaporins (AQPs), including AQP1-8 and AQP11, have been found and are differentially expressed along the renal tubules and collecting ducts with distinct and critical roles in the regulation of body water homeostasis and urine concentration. Dysfunction and dysregulation of these AQPs result in various water balance disorders. This review summarizes current understanding of physiological and pathophysiological roles of AQPs in the kidney, with a focus on recent progress on AQP2 regulation by the nuclear receptor transcriptional factors...
January 1, 2020: American Journal of Physiology. Renal Physiology
https://read.qxmd.com/read/31651865/a-new-method-of-intermittent-lower-dose-of-tolvaptan-combined-with-fluid-restriction-to-treat-the-syndrome-of-inappropriate-antidiuresis-a-case-report
#29
JOURNAL ARTICLE
Xianxian Yuan, Hui Pan, Huijuan Zhu, Jiapei Li, Hui Miao, Xiaoan Ke, Shi Chen
RATIONALE: Tolvaptan, an oral vasopressin V2 receptor antagonist, is a new approach for the treatment of adult patients with the syndrome of inappropriate antidiuresis (SIADH). However, dose-dependent side effect including rapid increase in serum sodium levels and liver injury, and the expensive price limit the long-term use of tolvaptan. We report a case of SIADH patient treated with intermittent lower dose of tolvaptan combined with fluid restriction. PATIENT CONCERNS: A 60-year-old woman presented of nausea and vomiting, dizzy and amaurosis, and transient disturbance, after a week of persistent diarrhea...
October 2019: Medicine (Baltimore)
https://read.qxmd.com/read/31410325/tolvaptan-induced-liver-injury-who-is-at-risk-a-case-report-and-literature-review
#30
Muhammad Y Khan, Muhammad Shabbir Rawala, Maryam Siddiqui, Waqas Abid, Aysha Aslam
Hyponatremia is a common clinical condition encountered in the hospital setting. Syndrome of inappropriate antidiuretic hormone (SIADH) is an important and one of the most common causes of hyponatremia. SIADH accounts for approximately one-third of all cases of hyponatremia. Tolvaptan is a vasopressin receptor antagonist used to treat SIADH. Hepatoxicity is a rare yet dangerous side effect from Tolvaptan use. We present a case of cholestatic liver injury in an elderly female who presented with hyponatremia...
June 5, 2019: Curēus
https://read.qxmd.com/read/31315326/efficacy-and-safety-of-oral-tolvaptan-therapy-in-hospitalized-cirrhotic-patients-with-hyponatremia
#31
JOURNAL ARTICLE
Ravinder Garg, Kamalpreet Kaur, Simmi Aggarwal, Navtej Singh
Background: Tolvaptan is an orally administered, nonpeptide, selective arginine vasopressin V(2) receptor antagonist that increases free water clearance, thereby correcting and increasing the low serum sodium levels in patients of cirrhosis, where hyponatremai is am major encountered problem. Aims: Evaluate the efficacy and tolerabilty of tolvaptan in cirrhotics with symptomatic hyponatremia that resist correction with fluid restriction. Intellectual improvement assessed using Short Portable Mental Status Questionnaire (SPMSQ) pre and post therapy(on conclusion)...
December 2018: Journal of the Association of Physicians of India
https://read.qxmd.com/read/31277136/hypernatremia-induced-by-low-dose-tolvaptan-in-a-patient-with-refractory-heart-failure-a-case-report
#32
JOURNAL ARTICLE
Tian Li, Gui-Shuang Li
RATIONALE: Tolvaptan (TLV) is a selective vasopressin type 2 receptor antagonist, which has an active effect on patients with congestive heart failure especially combined with hyponatremia. Increasingly, evidence has demonstrated that low-dose tolvaptan can dramatically relieve patients' dyspnea and the dose would not cause severe electrolyte abnormalities. Even hypernatremia is a major adverse effect of tolvaptan, treatment with tolvaptan shows good security and is well-tolerated. Few cases have reported that patients who developed severe hypernatremia induced by low-dose Tolvaptan...
July 2019: Medicine (Baltimore)
https://read.qxmd.com/read/31161520/impact-of-serum-albumin-levels-on-the-body-fluid-response-to-tolvaptan-in-chronic-kidney-disease-patients
#33
JOURNAL ARTICLE
Takahiro Masuda, Ken Ohara, Izumi Nagayama, Ryo Matsuoka, Takuya Murakami, Saki Nakagawa, Kentanro Oka, Maki Asakura, Yusuke Igarashi, Yukimura Fukaya, Yasuharu Miyazawa, Akito Maeshima, Tetsu Akimoto, Osamu Saito, Daisuke Nagata
PURPOSE: Tolvaptan exerts an aquaretic effect by blocking vasopressin V2 receptor. Although tolvaptan ameliorates body fluid retention even in patients with chronic kidney disease (CKD), predictors of body fluid reduction induced by tolvaptan remain unclear. We, therefore, examined the clinical parameters associated with the effect of tolvaptan on fluid volume in CKD patients. METHODS: Twelve CKD patients (stage 3-5) with fluid retention were treated with tolvaptan in addition to conventional diuretic treatment...
September 2019: International Urology and Nephrology
https://read.qxmd.com/read/31048435/effects-of-tolvaptan-add-on-therapy-in-patients-with-acute-heart-failure-meta-analysis-on-randomised-controlled-trials
#34
JOURNAL ARTICLE
Guang Ma, Xixi Ma, Guoliang Wang, Wei Teng, Xuezhi Hui
OBJECTIVES: Treating acute decompensated heartfailure (ADHF) for improving congestion with diuretics may cause worsening renal function (WRF), but the clinical efficacy of tolvaptan add-on therapy on reducing WRF in ADHF patients is inconsistent. This analysis is to evaluate the effects of tolvaptan add-on therapy on reducing WRF in ADHF patients. METHODS: Meta-analysis of randomised trials of tolvaptan add-on therapy on reducing WRF in ADHF patients. The MEDLINE, Embase and Cochrane Central Register of Controlled Trials databases were searched for relevant articles from their inception to 31 October, 2017...
May 1, 2019: BMJ Open
https://read.qxmd.com/read/31049746/a-quantitative-approach-to-intravenous-fluid-therapy-in-the-syndrome-of-inappropriate-antidiuretic-hormone-secretion
#35
JOURNAL ARTICLE
Philip J G M Voets, Nils P J Vogtländer
BACKGROUND: A wide range of interesting mathematical models has been derived to predict the effect of intravenous fluid therapy on the serum sodium concentration (most notably the Adrogué-Madias equation), but unfortunately, these models cannot be applied to patients with disorders characterized by aberrant antidiuretic hormone (ADH) release, such as the syndrome of inappropriate ADH secretion (SIADH). The use of intravenous fluids in these patients should prompt caution, as the inability of the kidneys to properly dilute the urine can easily result in deterioration of hyponatremia...
August 2019: Clinical and Experimental Nephrology
https://read.qxmd.com/read/31019923/safety-and-efficacy-of-tolvaptan-for-the-prevention-of-contrast-induced-acute-kidney-injury-in-patients-with-heart-failure-and-chronic-kidney-disease
#36
JOURNAL ARTICLE
Kennosuke Yamashita, Wataru Igawa, Morio Ono, Takehiko Kido, Toshitaka Okabe, Myong Hwa Yamamoto, Kisaki Amemiya, Naoei Isomura, Hiroshi Araki, Masahiko Ochiai
Background: Tolvaptan is a promising drug for the prevention of contrast-induced acute kidney injury (CI-AKI) because it induces aquaresis without adversely affecting renal hemodynamics. CI-AKI is a major cause of acute renal failure associated with increased morbidity and mortality. Objective: To investigate the effectiveness of different doses of tolvaptan for the prevention of CI-AKI. Method: Ninety-one consecutive patients with congestive heart failure (CHF) and chronic kidney disease (CKD) were prospectively enrolled as the tolvaptan group in this study (T-group; 7...
March 2019: Kidney Diseases
https://read.qxmd.com/read/31004513/copeptin-and-its-role-in-the-diagnosis-of-diabetes-insipidus-and-the-syndrome-of-inappropriate-antidiuresis
#37
REVIEW
Julie Refardt, Bettina Winzeler, Mirjam Christ-Crain
Copeptin is secreted in an equimolar amount to arginine vasopressin (AVP) but can easily be measured in plasma or serum with a sandwich immunoassay. The main stimuli for copeptin are similar to AVP, that is an increase in osmolality and a decrease in arterial blood volume and pressure. A high correlation between copeptin and AVP has been shown. Accordingly, copeptin mirrors the amount of AVP in the circulation. Copeptin has, therefore, been evaluated as diagnostic biomarker in vasopressin-dependent disorders of body fluid homeostasis...
July 2019: Clinical Endocrinology
https://read.qxmd.com/read/28302292/short-term-effects-of-tolvaptan-in-patients-with-acute-heart-failure-and-volume-overload
#38
RANDOMIZED CONTROLLED TRIAL
Marvin A Konstam, Michael Kiernan, Arthur Chandler, Ravi Dhingra, Freny Vaghaiwalla Mody, Howard Eisen, W Herbert Haught, Lynne Wagoner, Divya Gupta, Richard Patten, Paul Gordon, Kenneth Korr, Russell Fileccia, Susan J Pressler, Douglas Gregory, Patricia Wedge, Douglas Dowling, Matthew Romeling, Jeremy M Konstam, Joseph M Massaro, James E Udelson
BACKGROUND: In patients with acute heart failure (AHF), dyspnea relief is the most immediate goal. Renal dysfunction, diuretic resistance, and hyponatremia represent treatment impediments. OBJECTIVES: It was hypothesized that the addition of tolvaptan to a background diuretic improved dyspnea early in patients selected for an enhanced vasopressin antagonism response. METHODS: In a double-blind trial, patients were randomized to tolvaptan 30 mg/day or placebo...
March 21, 2017: Journal of the American College of Cardiology
https://read.qxmd.com/read/30868608/urea-in-cancer-patients-with-chronic-siad-induced-hyponatremia-old-drug-new-evidence
#39
JOURNAL ARTICLE
Alice Nervo, Valentina D'Angelo, Daniela Rosso, Eleonora Castellana, Francesco Cattel, Emanuela Arvat, Emidio Grossi
BACKGROUND: Syndrome of inappropriate antidiuresis (SIAD) is the main cause of hyponatremia in cancer patients. International guidelines indicate urea as an interesting option for chronic SIAD. Nevertheless, strong data to support its use are lacking, and its role in oncologic patients has not been described so far. MATERIAL AND METHODS: We retrospectively analysed 36 cancer patients affected by moderate or profound SIAD-induced chronic hyponatremia, who started oral urea (initial daily dose 15 g or 30 g) without fluid restriction between July 2013 and July 2018...
June 2019: Clinical Endocrinology
https://read.qxmd.com/read/30800291/vasopressin-aquaporin-2-pathway-recent-advances-in-understanding-water-balance-disorders
#40
REVIEW
Marianna Ranieri, Annarita Di Mise, Grazia Tamma, Giovanna Valenti
The alteration of water balance and related disorders has emerged as being strictly linked to the state of activation of the vasopressin-aquaporin-2 (vasopressin-AQP2) pathway. The lack of responsiveness of the kidney to the vasopressin action impairs its ability to concentrate the urine, resulting in polyuria, polydipsia, and risk of severe dehydration for patients. Conversely, non-osmotic release of vasopressin is associated with an increase in water permeability in the renal collecting duct, producing water retention and increasing the circulatory blood volume...
2019: F1000Research
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