Title |
Tolvaptan treatment improves survival of cirrhotic patients with ascites and hyponatremia
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Published in |
BMC Gastroenterology, September 2018
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DOI | 10.1186/s12876-018-0857-0 |
Pubmed ID | |
Authors |
Shuzhen Wang, Xin Zhang, Tao Han, Wen Xie, Yonggang Li, Hong Ma, Roman Liebe, Honglei Weng, Hui-Guo Ding |
Abstract |
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. 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. 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). Tolvaptan improves short term survival in most decompensated cirrhotic hyponatremia patients with resolved serum sodium. 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. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 20 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Doctoral Student | 3 | 15% |
Student > Master | 3 | 15% |
Other | 2 | 10% |
Professor > Associate Professor | 2 | 10% |
Researcher | 2 | 10% |
Other | 1 | 5% |
Unknown | 7 | 35% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 9 | 45% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 5% |
Nursing and Health Professions | 1 | 5% |
Engineering | 1 | 5% |
Unknown | 8 | 40% |