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KMID : 1128320110090020050
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Electrolytes & Blood Pressure
2011 Volume.9 No. 2 p.50 ~ p.54
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V2 Receptor Antagonist; Tolvaptan
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Yi Joo-Hark
Shin Hyun-Jong
Kim Ho-Jung
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Abstract
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Hyponatremia is the most common electrolyte disorder in hospitalized patients. Many studies documented that it was related to increased morbidity and mortality in patients with congestive heart failure, liver cirrhosis, and neurologic diseases. Although knowledge of hyponatremia has been cumulated, the optimal management of hyponatremia remains incompletely established in clinical practice because of the diversity of underlying disease states, and its multiple causes with differing pathophysiologic mechanisms. Since vasopressin receptor antagonists have unique aquaretic effect to selectively increase electrolytesfree water excretion, clinicians could apply a more effective method to treat hyponatremia. Tolvaptan has significant evidence that it improves serum sodium levels in patients with euvolemic or hypervolemic hyponatremia related with heart failure, cirrhosis or syndrome of inappropriate antidiuretic hormone. Tolvaptan has acceptable safety and tolerability for longterm usage in chronic hyponatremia, and the beneficial effects on serum Na+ occurred in patients with both mild and marked hyponatremia.
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KEYWORD
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tolvaptan, hyponatremia, arginine vasopressin receptors
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