Eficacia de tolvaptán en pacientes ingresados por insuficiencia cardiaca e hiponatremia refractaria. Experiencia en la práctica clínica diaria

Salterain-González, Nahikari; Esteban‐Fernández, Alberto; García–López, Martín; Lavilla-Royo, Francisco J.; Gavira-Gómez, Juan J.

doi:10.1016/j.recesp.2012.12.015

Cited by 5 publications

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“…Tras la publicación de varios ensayos y experiencias en la práctica clínica, se ha demostrado la efectividad del tolvaptan, un fármaco con efecto predominantemente acuarético, en el incremento de las cifras de Na y la diuresis, sin afectar a otros electrolitos ni a la función renal 4 .…”

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Experiencia inicial en el tratamiento ambulatorio con tolvaptan en pacientes con insuficiencia cardiaca avanzada

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Experiencia inicial en el tratamiento ambulatorio con tolvaptan en pacientes con insuficiencia cardiaca avanzada

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Benefit of tolvaptan in the management of hyponatraemia in patients with diuretic‐refractory congestive heart failure: the SEMI‐SEC project

et al. 2017

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Aims Hyponatraemia is an electrolyte disorder that occurs in advanced congestive heart failure (HF) and worsens prognosis. We explored the usefulness of tolvaptan, which has shown promising results in the treatment of this condition. Methods and resultsThis study is based on a retrospective national registry (2011-15) of patients hospitalized with refractory HF and hyponatraemia who agreed to receive tolvaptan when standard treatment was ineffective. The benefit of tolvaptan was analysed according to the following criteria: normalization ([Na + ] ≥ 135 mmol/L) or increased sodium levels [Na + ] ≥ 4 mEq/L on completion of treatment, and increase in urine output by 300 or 500 mL at 48 h. Factors associated with tolvaptan benefit were explored. A total of 241 patients were included, 53.9% of whom had ejection fraction <40%. All patients received concomitant loop diuretics. Initial tolvaptan dose was 17.2 AE 6.1 mg, and end dose was 26.4 AE 23.2 mg (duration 7.8 AE 8.6 days). Serum sodium concentrations increased significantly at 24-48 h, from 126.5 AE 6.2 mEq/L at baseline to 134.1 AE 6.1 mEq/L at the end of treatment (P < 0.0001). Weight fell by~5 kg before discharge (P < 0.0001) and urine output increased 1.3-fold (P < 0.0001). Normal sodium levels and/or increases of 500 mL in urine output were achieved by 90.8% of patients (35.7% achieved both) and 94.8% increased to [Na + ] ≥ 4 mEq/L and/or +300 mL in urine output (54.4% both).Conclusions An increase in sodium levels and/or improvement in urine output was observed in patients admitted for HF and refractory hyponatraemia under tolvaptan treatment. Tolvaptan may be useful in this setting, in which no effective proven alternatives are available.

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Hiponatremia e insuficiencia cardiaca congestiva refractaria a tratamiento diurético. Utilidad del tolvaptán

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et al. 2017

Revista Clínica Española

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Eficacia de tolvaptán en pacientes ingresados por insuficiencia cardiaca e hiponatremia refractaria. Experiencia en la práctica clínica diaria

Cited by 5 publications

References 6 publications

Experiencia inicial en el tratamiento ambulatorio con tolvaptan en pacientes con insuficiencia cardiaca avanzada

Experiencia inicial en el tratamiento ambulatorio con tolvaptan en pacientes con insuficiencia cardiaca avanzada

Benefit of tolvaptan in the management of hyponatraemia in patients with diuretic‐refractory congestive heart failure: the SEMI‐SEC project

Hiponatremia e insuficiencia cardiaca congestiva refractaria a tratamiento diurético. Utilidad del tolvaptán

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