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
Jesse H MorrisJuan Carlos Q Velez

Abstract

Tolvaptan effectively corrects hyponatremia due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), but undesired overcorrection can occur. We hypothesized that pretherapy parameters can predict the rapidity of response to tolvaptan in SIADH. Multicenter historical cohort study. Adults with SIADH or congestive heart failure (CHF) treated with tolvaptan for a serum sodium concentration ≤ 130 mEq/L at 5 US hospitals. Demographic and laboratory parameters. Rate of change in serum sodium concentration. Spearman correlations, analysis of variance, and multivariable linear mixed-effects models. 28 patients with SIADH and 39 patients with CHF treated with tolvaptan (mean baseline serum sodium, 120.6 and 122.4 mEq/L, respectively) were studied. Correction of serum sodium concentration > 12 mEq/L/d occurred in 25% of patients with SIADH compared to 3% of those with CHF (P<0.001). Among patients with SIADH, the increase in serum sodium over 24 hours was correlated with baseline serum sodium concentration (r=-0.78; P<0.001), serum urea nitrogen concentration (SUN; r=-0.76; P<0.001), and estimated glomerular filtration rate (r=0.58; P=0.01). Baseline serum sodium and SUN concentrations were identified as independent...Continue Reading

Citations

Jun 25, 2019·Current Opinion in Nephrology and Hypertension·Ewout J Hoorn, Goce Spasovski
Aug 28, 2019·Journal of General Internal Medicine·Jason D Woodfine, Carl van Walraven
Oct 1, 2019·JAAPA : Official Journal of the American Academy of Physician Assistants·Rebecca Boyle
Jun 14, 2019·Clinical Journal of the American Society of Nephrology : CJASN·Jason D WoodfineCarl van Walraven
Feb 6, 2020·Journal of the American Society of Nephrology : JASN·Julie RefardtMirjam Christ-Crain
Jan 30, 2021·Deutsche medizinische Wochenschrift·Ralph Kettritz
Mar 12, 2021·The Journal of Clinical Endocrinology and Metabolism·Victoria Chatzimavridou-GrigoriadouClaire E Higham

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