Journal ArticleDOI
Diagnosis, Evaluation, and Treatment of Hyponatremia: Expert Panel Recommendations
Joseph G. Verbalis,Steven R. Goldsmith,Arthur Greenberg,Cynthia A. Korzelius,Robert W. Schrier,Richard H. Sterns,Christopher J. Thompson +6 more
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TLDR
The updated expert panel recommendations in this document represent recommended approaches for multiple etiologies of hyponatremia that are based on both consensus opinions of experts in hypon atremia and the most recent published data in this field.About:
This article is published in The American Journal of Medicine.The article was published on 2013-10-01. It has received 700 citations till now. The article focuses on the topics: Hyponatremia & Syndrome of inappropriate antidiuretic hormone secretion.read more
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Journal ArticleDOI
Disorders of Plasma Sodium — Causes, Consequences, and Correction
TL;DR: This review considers the causes and consequences of an abnormal plasma sodium concentration and offers a framework for correcting it.
Journal ArticleDOI
Diagnosis and treatment of hyponatremia: a systematic review of clinical practice guidelines and consensus statements
Evi V. Nagler,Evi V. Nagler,Evi V. Nagler,Jill Vanmassenhove,Sabine N. van der Veer,Ionut Nistor,Wim Van Biesen,Wim Van Biesen,Angela C Webster,Angela C Webster,Raymond Vanholder,Raymond Vanholder +11 more
TL;DR: Current guidance documents on the assessment and treatment of hyponatremia vary in methodological rigor and recommendations are not always consistent.
Journal ArticleDOI
National Athletic Trainers' Association Position Statement: Fluid Replacement for the Physically Active
Brendon P. McDermott,Scott A. Anderson,Lawrence E. Armstrong,Douglas J. Casa,Samuel N. Cheuvront,Larry Cooper,W. Larry Kenney,Francis G. O'Connor,William O. Roberts +8 more
TL;DR: This statement updates practical recommendations regarding fluid-replacement strategies for physically active individuals and educates physically active people regarding the benefits of fluid replacement to promote performance and safety and the potential risks of both hypohydration and hyperhydration on health and physical performance.
Journal ArticleDOI
Diagnosis and Treatment of Hyponatremia: Compilation of the Guidelines.
Ewout J. Hoorn,Robert Zietse +1 more
TL;DR: The diagnosis and treatment of hyponatremia is discussed, comparing the two guidelines and highlighting recent developments, including fractional uric acid excretion and plasma copeptin concentration, which may further improve the diagnostic approach.
Journal ArticleDOI
Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome: 2021 Practice Guidance by the American Association for the Study of Liver Diseases
Scott W. Biggins,Paulo Angeli,Guadalupe Garcia-Tsao,Pere Ginès,Simon C. Ling,Mitra K. Nadim,Florence Wong,W. Ray Kim +7 more
References
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Journal ArticleDOI
Peripheral arterial vasodilation hypothesis: a proposal for the initiation of renal sodium and water retention in cirrhosis.
TL;DR: The stimulation of the renin‐angiotensin‐aldosterone system, vasopressin release and sympathetic nervous system associated with cirrhosis is not consonant with primary volume expansion, and favors the “overflow” hypothesis.
Journal ArticleDOI
Effects of Oral Tolvaptan in Patients Hospitalized for Worsening Heart Failure: The EVEREST Outcome Trial
Marvin A. Konstam,Mihai Gheorghiade,John C. Burnett,Liliana Grinfeld,Aldo P. Maggioni,Karl Swedberg,James E. Udelson,Faiez Zannad,Thomas D. Cook,John Ouyang,Christopher Zimmer,Cesare Orlandi +11 more
TL;DR: Tolvaptan initiated for acute treatment of patients hospitalized with heart failure had no effect on long-term mortality or heart failure-related morbidity.
Effects of Oral Tolvaptan in Patients Hospitalized for Worsening Heart Failure
Marvin A. Konstam,Mihai Gheorghiade,John C. Burnett,Liliana Grinfeld,Aldo P. Maggioni,Karl Swedberg,James E. Udelson,Faiez Zannad,John Ouyang,Christopher Zimmer,Cesare Orlandi +10 more
Abstract: CONTEXT
Vasopressin mediates fluid retention in heart failure. Tolvaptan, a vasopressin V2 receptor blocker, shows promise for management of heart failure.
OBJECTIVE
To investigate the effects of tolvaptan initiated in patients hospitalized with heart failure.
DESIGN, SETTING, AND PARTICIPANTS
The Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan (EVEREST), an event-driven, randomized, double-blind, placebo-controlled study. The outcome trial comprised 4133 patients within 2 short-term clinical status studies, who were hospitalized with heart failure, randomized at 359 North American, South American, and European sites between October 7, 2003, and February 3, 2006, and followed up during long-term treatment.
INTERVENTION
Within 48 hours of admission, patients were randomly assigned to receive oral tolvaptan, 30 mg once per day (n = 2072), or placebo (n = 2061) for a minimum of 60 days, in addition to standard therapy.
MAIN OUTCOME MEASURES
Dual primary end points were all-cause mortality (superiority and noninferiority) and cardiovascular death or hospitalization for heart failure (superiority only). Secondary end points included changes in dyspnea, body weight, and edema.
RESULTS
During a median follow-up of 9.9 months, 537 patients (25.9%) in the tolvaptan group and 543 (26.3%) in the placebo group died (hazard ratio, 0.98; 95% confidence interval [CI], 0.87-1.11; P = .68). The upper confidence limit for the mortality difference was within the prespecified noninferiority margin of 1.25 (P<.001). The composite of cardiovascular death or hospitalization for heart failure occurred in 871 tolvaptan group patients (42.0%) and 829 placebo group patients (40.2%; hazard ratio, 1.04; 95% CI, 0.95-1.14; P = .55). Secondary end points of cardiovascular mortality, cardiovascular death or hospitalization, and worsening heart failure were also not different. Tolvaptan significantly improved secondary end points of day 1 patient-assessed dyspnea, day 1 body weight, and day 7 edema. In patients with hyponatremia, serum sodium levels significantly increased. The Kansas City Cardiomyopathy Questionnaire overall summary score was not improved at outpatient week 1, but body weight and serum sodium effects persisted long after discharge. Tolvaptan caused increased thirst and dry mouth, but frequencies of major adverse events were similar in the 2 groups.
CONCLUSION
Tolvaptan initiated for acute treatment of patients hospitalized with heart failure had no effect on long-term mortality or heart failure-related morbidity.
TRIAL REGISTRATION
clinicaltrials.gov Identifier: NCT00071331
Journal ArticleDOI
Tolvaptan in patients with autosomal dominant polycystic kidney disease
Vicente E. Torres,Arlene B. Chapman,Olivier Devuyst,Olivier Devuyst,Ron T. Gansevoort,Jared J. Grantham,Eiji Higashihara,Ronald D. Perrone,Holly B. Krasa,John Ouyang,Frank S. Czerwiec +10 more
TL;DR: Tolvaptan, as compared with placebo, slowed the increase in total kidney volume and the decline in kidney function over a 3-year period in patients with ADPKD but was associated with a higher discontinuation rate, owing to adverse events.