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KMID : 0882420120820010022
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Korean Journal of Medicine
2012 Volume.82 No. 1 p.22 ~ p.31
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Efficacy of Vaptans for Management of Ascites in Patients with Liver Cirrhosis
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Choe Won-Hyeok
Lee June-Sung
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Abstract
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Ascites is the most common complication of liver cirrhosis, but its pharmacological management is unsatisfactory in some patients because of a lack of response to treatment with conventional diuretics. Patients with cirrhosis and ascites generally have increased non-osmotic secretion of vasopressin which participates in the pathogenesis of fluid retention. Vaptans are a new family of orally active drugs that increase urine volume by antagonizing specifically the vasopressin receptors in the principal cells of the collecting ducts that have been shown to correct dilutional hyponatremia effectively. They also seem to be promising in the management of ascites by reducing the increased extracellular fluid volume in conditions associated with water retention including liver cirrhosis. However, there is a paucity of information on whether vaptans might have beneficial effect in enhancing ascites reduction in patients with cirrhosis. This review addresses the pharmacological actions of vaptans, their clinical applications, and future potential roles in managing patients with liver cirrhosis and ascites.
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KEYWORD
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Ascites, Aquaresis, Hyponatremia, Liver cirrhosis, Vaptans, Vasopressin
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