TY  - JOUR
VL  - 18
EP  - 8
PB  - BioMed Central
SP  - 1
TI  - Tolvaptan treatment improves survival of cirrhotic patients with ascites and hyponatremia
AV  - public
ID  - heidok25459
JF  - BMC Gastroenterology
A1  - Wang, Shuzhen
A1  - Zhang, Xin
A1  - Han, Tao
A1  - Xie, Wen
A1  - Li, Yonggang
A1  - Ma, Hong
A1  - Liebe, Roman
A1  - Weng, Honglei
A1  - Ding, Hui-Guo
N2  - Background: Although tolvaptan treatment improves hyponatremia, only few studies have investigated whether tolvaptan actually benefits the survival of cirrhotic patients. This study evaluated the impact of tolvaptan on six-month survival of decompensated cirrhotic patients with and without hyponatremia.   

Methods: Two hundred forty-nine decompensated cirrhotic patients with or without hyponatremia were enrolled in a multicenter cohort study. Patients were divided into two groups according to receiving either tolvaptan or placebo treatment for 7-day. Subsequently, the patients were followed up for 6 months.   

Results: Two hundred thirty patients, including 98 with hyponatremia (tolvaptan vs. placebo: 69 vs. 29) finished the study. Tolvaptan did not alter serum sodium levels and survival outcome of decompensated cirrhotic patients without hyponatremia. However, tolvaptan treatment remarkably improved serum sodium levels and six-month survival in patients with hyponatremia. Following tolvaptan treatment, serum sodium levels were restored to normal in 63.8% of patients, whereas in patients receiving placebo, only 36.2% showed the same effect (P?<?0.05). Compared to a six-month survival rate of 68.97% in patients receiving placebo, the survival rate in tolvapatan-treated patients was 89.94% (P?<?0.05). Furthermore, six-month survival rate in the tolvaptan-treated hyponatremia patients with resolved serum sodium was 81.32%, whereas the survival in those with unresolved serum sodium was only 24% (P?<?0.05).

Conclusions: Tolvaptan improves short term survival in most decompensated cirrhotic hyponatremia patients with resolved serum sodium.

Trials registration: Clinical trial one: ClinicalTrials.gov ID: NCT00664014  , Registered on April 14, 2008. Clinical trial two: ClinicalTrials.gov ID: NCT01349335  , Registered on March 5, 2010. Clinical trial three: ClinicalTrials.gov ID: NCT01349348  , Registered on May 4, 2011.
UR  - https://archiv.ub.uni-heidelberg.de/volltextserver/25459/
CY  - London
SN  - 1471-230X
Y1  - 2018///
IS  - 137
ER  -