ECE2018 Poster Presentations: Pituitary and Neuroendocrinology Pituitary - Clinical (101 abstracts)
Tolvaptan usage in hyponatremic patients with syndrome of inappropriate secretion of antidiuretic hormone: a single-center experience
Suat Akgür 1 , Ayşegül Oruç 1 , Abdülmecit Yıldız 1 , Canan Ersoy 2 , Mustafa Güllülü 1 , Mahmut Yavuz 1 , Kamil Dilek 1 & Alparslan Ersoy 1
1Uludag University Medical Faculty, Department of Nephrology, Bursa, Turkey; 2Uludağ University Medical Faculty, Department of Endocrinology and Metabolism, Bursa, Turkey.
The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is a disorder of impaired water excretion caused by inability to suppress secretion of antidiuretic hormone. The therapy of SIADH varies with severity of hyponatremia and presence or absence of symptoms. Non-peptide vasopressin receptor antagonists (vaptans) are effective at increasing sodium in euvolemic and hypervolemic states and appear safe. We aimed to evaluate the efficacy of tolvaptan in euvolemic hyponatremic patients with SIADH.
Methods: The study included 13 euvolemic hyponatremic (serum sodium level <125 mmol/l) patients with idiopathic SIADH between January – December 2017. The diagnosis of SIADH was made with hyponatremia, hypoosmolality, urine sodium level above 40 mEq/l and urine osmolality above 100 mosmol/kg. Serum potassium levels of all patients were normal, there was no acid-base disturbance. Patients with hypervolemic or hypovolemic status and hepatic dysfunction were excluded from the study. All patients received 7.5 mg/day of tolvaptan therapy. Clinical and laboratory data of patients were obtained before and after treatment.
Results: The mean age of patients (11 females, 2 males) was 74.6±10.9 years (range 57–95). There was type 2 diabetes mellitus in 5 (38.5) patients, hypertension in 12 (92.3%) patients and chronic kidney disease in 7 (53.8) patients. The mean sodium levels before tolvaptan treatment were 120.5±2.2 mmol/l (range 116–124). The mean sodium levels increased to 132.6±4.0 mmol/l (range 125–140) after tolvaptan treatment at 2.7±1.3 days (range 2–6). This increase in the sodium levels was significant (P<0.001). In a patient, hyponatremia recurred after ten days and corrected with two doses of tolvaptan. We did not observe serious adverse event related with tolvaptan treatment.
Conclusion: Our study suggested that hyponatremia was a common problem in elderly patients who had co-morbidities. Tolvaptan can treat hyponatremia effectively and safely in euvolemic elderly patients with SIADH.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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