eprintid: 25459 rev_number: 11 eprint_status: archive userid: 1589 dir: disk0/00/02/54/59 datestamp: 2018-10-25 12:58:46 lastmod: 2024-03-10 05:09:04 status_changed: 2018-10-25 12:58:46 type: article metadata_visibility: show creators_name: Wang, Shuzhen creators_name: Zhang, Xin creators_name: Han, Tao creators_name: Xie, Wen creators_name: Li, Yonggang creators_name: Ma, Hong creators_name: Liebe, Roman creators_name: Weng, Honglei creators_name: Ding, Hui-Guo title: Tolvaptan treatment improves survival of cirrhotic patients with ascites and hyponatremia subjects: 610 divisions: 62300 abstract: 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. date: 2018 publisher: BioMed Central id_scheme: DOI ppn_swb: 1657379116 own_urn: urn:nbn:de:bsz:16-heidok-254597 language: eng bibsort: WANGSHUZHETOLVAPTANT2018 full_text_status: public publication: BMC Gastroenterology volume: 18 number: 137 place_of_pub: London pagerange: 1-8 issn: 1471-230X citation: Wang, Shuzhen ; Zhang, Xin ; Han, Tao ; Xie, Wen ; Li, Yonggang ; Ma, Hong ; Liebe, Roman ; Weng, Honglei ; Ding, Hui-Guo (2018) Tolvaptan treatment improves survival of cirrhotic patients with ascites and hyponatremia. BMC Gastroenterology, 18 (137). pp. 1-8. ISSN 1471-230X document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/25459/1/12876_2018_Article_857.pdf