Hyponatremia in critical care patients: Frequency, outcome, characteristics, and treatment with the vasopressin V2-receptor antagonist tolvaptan

Friedman, Bruce; Cirulli, Joshua

doi:10.1016/j.jcrc.2012.06.001

Cited by 41 publications

(25 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nowadays, there were not effective alternatives for these patients except for extrarenal purification methods. Vasopressin V2‐receptor antagonist has been proposed in the management of hypervolemic hyponatremia in critical care patients . In our short experience, tolvaptan rapidly decreases fluid overload in critically ill patients, without important adverse events.…”

Section: Details Of the Casementioning

confidence: 88%

Initial experience of use of tolvaptan in critically ill patients with fluid overload

et al. 2015

View full text Add to dashboard Cite

show abstract

Section: Details Of the Casementioning

confidence: 88%

Initial experience of use of tolvaptan in critically ill patients with fluid overload

et al. 2015

View full text Add to dashboard Cite

show abstract

“…We found that hyponatremia was higher than expected in non-tubercular patients according to the previous reports. In previous studies, the prevalence of hyponatremia among inpatients, especially the ones who admitted in respiratory wards, was reported in a various range (2.48%-40%) (16, 17). This issue can be related to the type of diseases and age.…”

Section: Discussionmentioning

confidence: 98%

Hyponatremia Due to Pulmonary Tuberculosis: Review of 200 Cases

et al. 2012

View full text Add to dashboard Cite

BackgroundPulmonary Tuberculosis (PTB) is one of the common diseases with high prevalence of mortality and morbidity in developing countries. Various complications have been reported along with PTB. The subclinical electrolyte imbalances are customary in cases with PTB.ObjectivesThe aim of this study was the evaluation of patients with PTB and hyponatremia.Patients and MethodsWe evaluated patients with diagnosis of secondary PTB who have been admitted to Baqiyatallah hospital, Tehran, Iran from 2005 till 2010. The diagnosis of PTB was based on the appearance of acid fast bacilli in sputum smears or sputum cultures, without any evidence of miliary TB. Demographic and laboratory characteristics relative to electrolytes were recorded according inclusion and exclusion criteria.ResultsThe mean age was 59.22 ± 20.57 years and 91 (45.5%) patients were male. The mean serum sodium concentration was 134.54 ± 4.95 mmol/L and more than half of subjects (51%) have shown hyponatremia. The mean age difference between hyponatremic and eunatremic groups was statistically significant (61.95 versus 56.02 years) (P = 0.047). No significant relationship was found between hyponatremia and gender, anti-TB medications and co-morbidity conditions.ConclusionsIn this study, an older age was suggested as an important predisposing factor for hyponatremia in patients with PTB which had been observed as less of a determinant. We recommend further evaluations for hyponatremia in patients presenting with PTB, particularly for those who are older.

show abstract

“…1) is a selective vasopressin V 2 -receptor antagonist that has been approved in U.S. for the treatment of clinically significant hypervolemic and euvolemic hyponatremia in patients with heart failure, cirrhosis, and the syndrome of inappropriate antidiuretic hormone secretion (SIADH) [1,2]. In Europe, tolvaptan is also approved for the treatment of patients with hyponatremia, secondary to SIADH.…”

Section: Introductionmentioning

confidence: 99%

Mechanisms of tolvaptan-induced toxicity in HepG2 cells

Beland

Chen

et al. 2015

Biochemical Pharmacology

View full text Add to dashboard Cite

Tolvaptan, a vasopressin receptor 2 antagonist used to treat hyponatremia, has recently been reported to be associated with an increased risk of liver injury. In this study, we explored the underlying mechanisms of hepatotoxicity of tolvaptan using human HepG2 cells. Tolvaptan inhibited cell growth and caused cell death in a concentration- and time-dependent manner. Tolvaptan treatment led to delayed cell cycle progression, accompanied by decreased levels of several cyclins and cyclin-dependent kinases. Tolvaptan was found to cause DNA damage, as assessed by alkaline comet assays; this was confirmed by increased levels of 8-oxoguanine and phosphorylation of histone H2AX. Exposure of HepG2 cells to tolvaptan enhanced cytochrome C release and triggered apoptosis by modulating Bcl-2 family members. The activation of p38 contributed to tolvaptan-mediated apoptosis via down-regulation of Bcl-2. Proteasome inhibition altered tolvaptan-induced cell cycle deregulation and enhanced tolvaptan-induced apoptosis and cytotoxicity. Moreover, tolvaptan treatment induced autophagy. Inhibition of autophagy by knocking-down an autophagy-related gene increased tolvaptan-induced apoptosis and cytotoxicity. Taken together, our findings suggest that the cytotoxicity of tolvaptan results from delayed cell cycle progression, the induction of DNA damage, and the execution of apoptosis. In addition, a number of signaling pathways were perturbed by tolvaptan and played an important role in its cytotoxicity.

show abstract

Hyponatremia in critical care patients: Frequency, outcome, characteristics, and treatment with the vasopressin V2-receptor antagonist tolvaptan

Cited by 41 publications

References 42 publications

Initial experience of use of tolvaptan in critically ill patients with fluid overload

Initial experience of use of tolvaptan in critically ill patients with fluid overload

Hyponatremia Due to Pulmonary Tuberculosis: Review of 200 Cases

Mechanisms of tolvaptan-induced toxicity in HepG2 cells

Contact Info

Product

Resources

About