Base de dados : LILACS
Pesquisa : D27.505.519.174 [Categoria DeCS]
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Id: biblio-838094
Autor: Jia, Ji-Dong; Xie, Wen; Ding, Hui-Guo; Mao, Hua; Guo, Hui; Li, Yonggang; Wang, Xiaojin; Wang, Jie-Fei; Lu, Wei; Li, Cheng-Zhong; Mao, Yimin; Wang, Gui-Qiang; Gao, Yue-qiu; Wang, Bangmao; Zhang, Qin; Ge, Yan; Wai-Sun Wong, Vincent.
Título: Utility and Safety of Tolvaptan in Cirrhotic Patients with Hyponatremia: a Prospective Cohort Study
Fonte: Ann. hepatol;16(1):123-132, Jan.-Feb. 2017. graf.
Idioma: en.
Resumo: Abstract: Introduction and aim. Hyponatremia is common in patients with decompensated cirrhosis and is associated with increased mortality. Tolvaptan, a vasopressor V2 receptor antagonist, can increase free wáter excretion, but its efficacy and safety in cirrhotic patients remain unclear. Material and methods. We studied the usage and safety of tolvaptan in cirrhotic patients in a real-life, non-randomized, multicenter prospective cohort study. Forty-nine cirrhotic patients with hyponatremia were treated with tolvaptan 15 mg daily, and 48 patients not treated with tolvaptan in the same period served as controls. Improvement in serum sodium level was defined as an increase in serum sodium from < 125 to ≥ 125 mmol/L or from 125-134 to ≥ 135 mmol/L on day 7. Results. Twenty-three (47%) patients in the tolvaptan group and 17 (35%) in the control group had normal serum sodium on day 7 (p = 0.25). Serum sodium improved in 30 (61%) patients in the tolvaptan group and 17 (35%) patients in the control group (p = 0.011). Adverse events occurred in 46-47% of patients in both groups, and tolvaptan was not associated with worsened liver function. No patient with normal serum sodium on day 7 died within 30 days of treatment, whereas 16% of those with persistent hyponatremia died (p = 0.0019). Conclusion. In conclusion, short-term tolvaptan treatment is safe and can improve serum sodium level in cirrhotic patients with hyponatremia. Normalization of serum sodium level is associated with better survival.
Descritores: Sódio/sangue
Benzazepinas/uso terapêutico
Antagonistas dos Receptores de Hormônios Antidiuréticos/uso terapêutico
Hiponatremia/tratamento farmacológico
Cirrose Hepática/complicações
-Fatores de Tempo
Benzazepinas/efeitos adversos
Biomarcadores/sangue
Estudos de Casos e Controles
China
Estudos Prospectivos
Fatores de Risco
Resultado do Tratamento
Estimativa de Kaplan-Meier
Antagonistas dos Receptores de Hormônios Antidiuréticos/efeitos adversos
Tolvaptan
Hiponatremia/etiologia
Hiponatremia/mortalidade
Hiponatremia/sangue
Cirrose Hepática/diagnóstico
Cirrose Hepática/mortalidade
Limites: Humanos
Pessoa de Meia-Idade
Idoso
Responsável: BR1.1 - BIREME


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Id: biblio-887468
Autor: Tejero Hernández, M. Angeles; García Martínez, Elena; Arroyo Marin, M. José; Gómez Guzmán, Elena.
Título: Tolvaptán en un caso de síndrome cardiorrenal pediátrico: ¿Cuál es su papel? / Tolvaptan in a pediatric cardiorenal syndrome: What is its role?
Fonte: Arch. argent. pediatr;116(2):279-282, abr. 2018. graf, tab.
Idioma: es.
Resumo: El síndrome cardiorrenal se define como la asociación de insuficiencia renal y cardíaca de forma aguda o crónica. Se establece una resistencia a los diuréticos convencionales que hace difícil el manejo de estos niños. El tolvaptán, un antagonista de los receptores de vasopresina, ha sido empleado con éxito en adultos, aunque la experiencia en niños es muy limitada. Se presenta el caso de una paciente de 5 años en lista de trasplante cardíaco que padecía síndrome cardiorrenal. Había tenido una hospitalización prolongada con buena respuesta a dosis mínimas de tolvaptán (0,1 mg/kg/día). Se analizaron las curvas de urea, creatinina, sodio y volumen urinario, y se evidenció una mejoría llamativa en la función renal. Al cuarto día de haber iniciado el tratamiento, se le pudo dar el alta con seguimiento ambulatorio y buena evolución hasta el trasplante. El tolvaptán podría considerarse una opción de tratamiento en niños con resistencia a diuréticos convencionales e insuficiencia cardíaca, especialmente, cuando presentan insuficiencia renal.

The cardiorenal syndrome has been defined as a situation in which therapy to relieve congestive symptoms of heart failure is limited by a decreased renal function. The resistance to conventional diuretic treatment makes difficult managing these patients. Tolvaptan, a selective vasopressin-2 receptor antagonist, has been used successfully in adults with this pathology but the experience with children is very limited. A five-year-old girl with renal failure waiting for a heart transplant is presented. Tolvaptan (0.1 mg/kg/day) was started at very low dosage, resulting in an excellent response. We analyzed the creatinine, urea, urine volume and sodium evolution. Renal function also improved. She could be discharged after four days of treatment (156 days of hospitalization) with ambulatory favourable follow-up until heart transplant. Tolvaptan should be considered in pediatric cases of conventional diuretic-resistant congestive heart failure, especially when complicated by kidney disease.
Descritores: Síndrome Cardiorrenal/tratamento farmacológico
Antagonistas dos Receptores de Hormônios Antidiuréticos/uso terapêutico
/uso terapêutico
FRUCTOSE-BISPHOSPHATE ALDOLASEABDOMEN/uso terapêutico
Limites: Humanos
Feminino
Pré-Escolar
Tipo de Publ: Relatos de Casos
Responsável: AR94.1 - Centro de Información Pediatrica


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Texto completo SciELO Chile
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Id: biblio-844524
Autor: Araujo Castro, Marta; Abad López, Ainhoa; Gutiérrez Sanz, Lourdes; Palacios García, Nuria.
Título: SIADH secundario a adenocarcinoma seroso de ovario tratado con tolvaptán / SIADH secondary to serous ovarian adenocarcinoma treated with tolvaptan
Fonte: Rev. chil. obstet. ginecol;81(6):507-510, dic. 2016. tab.
Idioma: es.
Resumo: La hiponatremia es la alteración electrolítica más frecuente en el medio hospitalario, y en un 30% de los casos se debe a un síndrome de secreción inapropiada de vasopresina (SIADH). El SIADH está descrito como cuadro paraneoplásico endocrinológico en múltiples tumores, entre los que excepcionalmente se encuentra el de ovario y las neoplasias ginecológicas en general. Presentamos un caso de SIADH paraneoplásico por un citoadenocarcinoma seroso de ovario de alto grado, estadio IV. Se trata del primer caso de SIADH crónico por cáncer de ovario tratado con Tolvaptán. En el presente caso el objetivo de eunatremia se alcanzó con una dosis baja de acuarético, lo que apoya la elevada sensibilidad, ya previamente documentada, de los SIADH tumorales al tratamiento con Tolvaptán.

Hyponatremia is the most common electrolyte disturbance in hospitals, and 30% of cases are due to syndrome of inappropriate secretion of antidiuretic hormone (SIADH). SIADH is described as an endocrine paraneoplastic syndrome in multiple tumors including, ovary and gynecological malignancies in general, although these are exceptional. We report a case of paraneoplastic SIADH for high-grade serous ovarian cystoadenocarcinoma stage IV. This is the first case of chronic SIADH for ovarian cancer treated with Tolvaptan. In this case the target of eunatremia was reached with a low dose of aquaretic, which supports the high sensitivity, as previously documented, of paraneoplasic SIADH to Tolvaptan.
Descritores: Benzazepinas/uso terapêutico
Hiponatremia/tratamento farmacológico
Síndrome de Secreção Inadequada de HAD/complicações
Síndrome de Secreção Inadequada de HAD/tratamento farmacológico
-Antagonistas dos Receptores de Hormônios Antidiuréticos/uso terapêutico
Cistadenocarcinoma Seroso/complicações
Hiponatremia/etiologia
Neoplasias Ovarianas/complicações
Limites: Humanos
Feminino
Adulto
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central



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