Preliminary observation of efficacy and safety of arginine vasopressin receptor antagonist in the treatment of syndrome of inappropriate secretion of antidiuretic hormone
10.3760/cma.j.issn.1673-4904.2014.10.001
- VernacularTitle:精氨酸加压素受体拮抗剂治疗抗利尿激素不适当分泌综合征的疗效和安全性初步观察
- Author:
Dan LIANG
;
Yao WANG
;
Liyong ZHONG
- Publication Type:Journal Article
- Keywords:
Inappropriate ADH syndrome;
Hyponatremia;
Arginine vasopressin receptor antagonist;
Tolvaptan
- From:
Chinese Journal of Postgraduates of Medicine
2014;37(10):1-5
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the efficacy and safety of arginine vasopressin receptor antagonist tolvaptan for treating hyponatremia caused by syndrome of inappropriate secretion of antidiuretic hormone (SIADH).Methods Six patients diagnosed with SIADH were enrolled in this study.Four cases were allocated to tolvaptan group (oral tolvaptan 15-60 mg/d,the dosage was adjusted based on the level of serum sodium).Two cases were allocated to regular treatment group (liquid was limited 1 000 ml/d,intravenous drip was less than 3％ sodium chloride and/or oral salt capsule 10-15 g/d several times was adjusted based on the level of serum sodium).Data of the level of serum sodium at 4,7 d,baseline value of serum sodium,serum sodium at the first normal time,24 h urine and weight change were collected.Safety assessment was given before and after treatment,including medical history,physical examination,electrocardiogram,laboratory tests,and incidence of adverse events.Results The level of serum sodium in tolvaptan group increased from the first day of the treatment.During the period of treatment,serum sodium at 4 d increased 22,16,14,11 mmol/L compared with the baseline value respectively.No obvious change of sodium was observed in regular treatment group compared with the baseline value.For 7 d treatment,serum sodium level increased 14,13,14,13 mmol/L in tolvaptan group compared with the baseline level respectively.Only 2 cases in regular treatment group increased 4 mmol/L,and sodium level in regular treatment group did not reach the lower limit of normal level of serum sodium.In tolvaptan group,all patients urine output increased after 1 d treatment and began to stabilize in 3 d.24 h urine putouts were much more than 1 500 ml during treatment.Urine putouts 780-1 400 ml were observed in regular treatment group.There was no difference before and after treatment.Although weight dropped after treatment in the two groups,weight in tolvaptan group fell obviously.In the two groups,there was no difference in blood pressure and heart rate before and after treatment.There were no serious complications and adverse events.Conclusions Compare with regular treatment,arginine vasopressin receptor antagonist is more effective therapy because it can correct the SIADH in patients with hyponatremia and reduce water retention.It also has a good security.
