Case report of domiciliary treatment with Tolvaptan in patients with advanced heart failure and persistent hyponatremia

Abstract

Management of patients with advanced heart failure and persistent hyponatremia remains a difficult challenge today. Classical treatment is not always enough, not only because of diuretics resistance, but also because of the natural course of heart failure and several comorbidities. Tolvaptan, a V2 receptor inhibitor in the kidneys, has demonstrated its utility and safety in refractory hyponatremia correction in patients with decompensated heart failure, but there is little experience about its use in management of chronic hyponatremia. We present a report of a case series with long term domiciliary treatment with Tolvaptan followed up in a Heart Failure unit.