5PSQ-027 Effectiveness and safety of tolvaptan and urea for the treatment of severe symptomatic hyponatraemia: a case series
Abstract
Background Tolvaptan and, recently, urea were both indicated for the treatment of hyponatraemia secondary to the Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) in our country. The FDA also contemplated its use in patients with heart failure (HF). Regarding safety of these drugs, patients with very low baseline natraemia may be at risk for too-rapid correction of serum sodium (>12 mEq/L/24 hours). Purpose To analyse the effectiveness and safety of tolvaptan and urea, and its use in relation to the diagnosis of hyponatraemia. Material and methods Retrospective observational study of all cases of severe symptomatic hyponatraemia diagnosed during 2016 in a tertiary care hospital and patients who started treatment with oral urea or tolvaptan during hospitalisation. Variables collected: etiology of hyponatraemia, analytical parameters, dose and duration of treatment. Results Seven patients treated with tolvaptan: four diagnosed with HF and three with SIADH. Dose ranged from 15 mg/day to 30 mg/day. Median duration: 7 days (2–28). Baseline and final mean natraemia: 119.8 mEq/L and 133 mEq/L respectively. Two patients with SIADH and one with HF had eunatraemia. Three patients were exitus. Six patients were treated with urea, five diagnosed with SIADH and one with adrenal insufficiency. Urea dose ranged from 15 g/day to 30 g/day. Median duration of treatment: 15 days (7–147), three patients continued at home. Baseline and final mean natraemia were 123.4 mEq/L and 133…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Global, regional, and national burden of hepatitis B, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
- A meta‐analysis of anal cancer incidence by risk group: Toward a unified anal cancer risk scale
- Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
- Exercise interventions in Alzheimer's disease: A systematic review and meta-analysis of randomized controlled trials
- Prognostic Significance of Carbonic Anhydrase IX Expression in Cancer Patients: A Meta-Analysis
- Glucocorticoid Resistance: Is It a Requisite for Increased Cytokine Production in Depression? A Systematic Review and Meta-Analysis
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.