Tolvaptan Response in a Hyponatremic Newborn with Syndrome of Inappropriate Secretion of Antidiuretic Hormone

Zeybek, Cengiz; Bozat, Ali Dinç; Çalışıcı, Erhan; Bolat, Ahmet; Karagöl, Belma Saygılı

doi:10.1155/2021/9920817

Cited by 2 publications

(8 citation statements)

References 22 publications

(29 reference statements)

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“…Individual sodium levels 48 hours and 10 days after tolvaptan or conivaptan treatment were documented in the cases presented in Figure 4. A correction of sodium of more than 16 mmol/L in 48 hours was observed in five out of 22 cases 14,17,29,31,36 …”

Section: Resultsmentioning

confidence: 94%

“…A skin rash was observed in one case, 24 and excessive thirst and dry mouth in seven cases 11,22 . Information on aminotransferase levels before and after treatment with tolvaptan was provided for 69 cases 18,20–22,27,28,31–33,36 . The mentioned parameters were within normal ranges both before and after treatment in 68 cases.…”

Section: Resultsmentioning

confidence: 98%

“…An initial oral tolvaptan dose of 0.38 ± 0.27 mg/kg body weight was given in 106 cases 11–25,27–34,36 . An identical tolvaptan dose was administered 24 hours later in 92 cases 11–14,16,18–25,27–29,32–34 .…”

Section: Resultsmentioning

confidence: 99%

“…The tolvaptan dose was increased (from 0.33 to 0.66 mg/kg body weight) respectively decreased (from 0.28 to 0.14 mg/kg body weight) in one case each 28,29 . A second dose of tolvaptan was not administered in the remaining 12 cases 15,17,30,31,36 . Intravenous conivaptan was administered in nine cases: an initial bolus of 0.34 ± 0.15 mg/kg body weight, 11–14 followed by maintenance of 0.34 ± 0.13 mg/kg body weight per day in eight cases 11–13 .…”

Section: Resultsmentioning

confidence: 99%

“…An initial oral tolvaptan dose of 0.38 ± 0.27 mg/kg body weight was given in 106 cases. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][27][28][29][30][31][32][33][34]36 An identical tolvaptan dose was administered 24 hours later in 92 cases. [11][12][13][14]16,[18][19][20][21][22][23][24][25][27][28][29][32][33][34] The tolvaptan dose was increased (from 0.33 to 0.66 mg/kg body weight) respectively decreased (from 0.28 to 0.14 mg/kg body weight) in one case each.…”

Section: Treatment With Vaptans For 48 Hoursmentioning

confidence: 99%

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Vaptans for oedematous and hyponatraemic disorders in childhood: A systematic literature review

Piffer

Bianchetti

Leoni-Foglia

et al. 2022

Brit J Clinical Pharma

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Aims The aim of this study was to systematically review the use of vaptans (nonpeptide vasopressin receptor antagonists) in children. Methods Through a database search (Web of Science, the National Library of Medicine, Excerpta Medica), we identified case series and case reports and extracted clinical and laboratory data. Results Twenty‐six articles, published since 2008, reported on 226 patients. Among 115 children with hyponatraemic (n = 63) and oedematous disorders (n = 52), a 48 hour course of tolvaptan with an initial dose of 0.38 ± 0.27 mg/kg was administered in 106 cases, while intravenous conivaptan was reported in nine cases. An increase (P < .02) in urine output was shown in both oedematous (from 3.2 ± 2.0 to 5.3 ± 6.7 mL/kg/day) and hyponatraemic (from 3.0 ± 1.5 to 4.4 ± 2.3 mL/kg/day) patients. In these latter, sodium increased from 125 ± 6 to 133 ± 6 mmol/L (P < .0001). The increase in sodium level correlated with its basal value, but not with the administered vaptan dose. Among 111 children undergoing cardiac surgery, after tolvaptan 0.21 ± 0.01 mg/kg/day, mostly combined with conventional diuretics, an increase in diuresis by 41 ± 4% was seen within 24 hours (P < .0001). Similarly, a single add‐on dose of tolvaptan 0.45 mg/kg allowed a reduced additional intravenous furosemide administration (0.26 ± 0.23 vs 0.62 ± 0.48 mg/kg, P < .005). Side effects were rarely reported, and included excessive thirst and xerostomia in seven, skin rash in one and elevated aminotransferases in one patient(s). Conclusion Vaptans appear to be safe for oedematous and hyponatraemic disorders also in children. Although they increase diuresis and natraemia, no superiority to traditional diuretics and sodium supplements has been demonstrated. Reported side effects are rare and non‐serious.

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Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Treatment With Vaptans For 48 Hoursmentioning

confidence: 99%

See 3 more Smart Citations

Vaptans for oedematous and hyponatraemic disorders in childhood: A systematic literature review

Piffer

Bianchetti

Leoni-Foglia

et al. 2022

Brit J Clinical Pharma

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A Conspectus of Euvolemic Hyponatremia, Its Various Etiologies, and Treatment Modalities: A Comprehensive Review of the Literature

Ghosal,

Qadeer,

Nekkanti

et al. 2023

Cureus

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Hyponatremia is the most prevalent electrolyte imbalance encountered among hospitalized patients, athletes, the elderly, patients with chronic ailments, postoperative patients, and a few asymptomatic individuals. Clinical manifestations of hyponatremia can be diverse, with characteristic neurological symptoms. Depending on in-depth medical history, physical examination (including volume status assessment), laboratory investigation, and drug history, patients can be classified broadly as undergoing hypervolemic, euvolemic, or hypovolemic hyponatremia. However, patients with hypervolemic hyponatremia often present with distinctive signs such as edema or ascites, and the clinical presentation of hypovolemic and euvolemic hyponatremia poses significant challenges for clinicians. The convolution in clinical manifestations of patients is due to the varied etiologies of euvolemic hyponatremia, such as syndrome of inappropriate antidiuretic hormone secretion (SIADH), adrenocortical insufficiency, hypothyroidism, psychogenic polydipsia, different classes of drugs (chemotherapeutics, antipsychotics, antidepressants), endurance exercise events, and reset osmostat syndrome (ROS). The management of hyponatremia depends on the rate of hyponatremia onset, duration, severity of symptoms, levels of serum sodium, and underlying comorbidities. Over the last decade, the clinical understanding of hyponatremia has been scattered due to the introduction of innovative laboratory markers and new drugs. This article will be a conspectus of all the recent advancements in the field of diagnosis, investigations, management, and associations of hyponatremia, along with traditional clinical practices. Subsequently, a holistic overview has been laid out for the clinicians to better understand and identify knowledge deficiencies on this topic.

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Tolvaptan Response in a Hyponatremic Newborn with Syndrome of Inappropriate Secretion of Antidiuretic Hormone

Cited by 2 publications

References 22 publications

Vaptans for oedematous and hyponatraemic disorders in childhood: A systematic literature review

Vaptans for oedematous and hyponatraemic disorders in childhood: A systematic literature review

A Conspectus of Euvolemic Hyponatremia, Its Various Etiologies, and Treatment Modalities: A Comprehensive Review of the Literature

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