CHF and SIADH has clear indications for use of vaptans. What is the data and evidence in cirrhosis associated hyponatremia?
1. No drug has been approved to treat hyponatremia of cirrhotics as of yet
2. Studies from Europe using lixivaptan and satavaptan have shown that short term effects of using them have had increased serum NA levels in cirrhotics and sustained for 1-2 weeks.
3. Unfortunately , only 27-54% had complete normalization of the Na
4. All studies showed increased urinary Na levels
5. Only one study has shown long term effects of captains in cirrhotics and that is using satavaptan.
The main finding was that the improvement in serum Na obtained in first days of therapy was maintained for one year.
6. Thirst was the biggest side effect.
7. To avoid rapid correction, use of D5W after reaching a certain threshold and matching urine output cc by cc is recommended as risk of ODS is there but not been reported thus far.
8. Patients awaiting liver transplantation should get treatment for Hyponatremia as there have been situations were Na corrects rapidly as the transplant is replaced and subsequently causing neurological sequelae.
- ► 2017 (48)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- Proteinuria: From a Medical Student's view
- The American Society of Transplantation Blog
- TOPIC DISCUSSION: SIROLIMUS , not all that benign
- In the NEWS: A novel treatment for Pre eclampsia- ...
- Consult rounds: Secondary causes RULE
- IN THE NEWS:- Renal Cell Cancer Research Update 20...
- A casual reminder; Abraham Verghese: A doctor's to...
- IN the NEWS: HB -EGF and RPGN
- Hypercalcemia in Pregnancy
- Topic Discussion: Diabetic Nephropathy Post Kidney...
- Topic Discussion: A Fresh Look at The Banff Classi...
- TOPIC DISCUSSION: Cirrhosis, Hyponatremia and the ...
- CLINICAL CASE 43: ANSWERS and SUMMARY
- Journal Club: SuPAR and FSGS
- Topic Discussion: Cathepsins and the Kidney
- Consult Rounds: Membranous Post Kidney Transplanta...
- IN THE NEWS:- Myeloproliferative neoplasms and glo...
- Consult Rounds: Hyperphosphatemia
- In The News:- HIV Nephropathy and other adverse ri...
- Topic Discussions: Genome-wide association studies...
- TOPIC DISCUSSION: Atypical HUS
- Topic Discussion: Recent Advances in Acute Kidney ...
- Nephrology Fellows Boot Camp
- IN the NEWS:- TIM-1 + B cells? and B cell toleranc...
- Happy Teacher's Day to all
- TOPIC DISCUSSION: Hemolysis and Renal dysfunction
- The Kidney Doctor: IMAGE OF THE MONTH
- CLINICAL CASE 42 : ANSWERS AND SUMMARY
- ▼ September (28)
- ► 2010 (461)