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Management of Cirrhotic Ascites under the Add-on Administration of Tolvaptan

Tolvaptan is a recently available diuretic that blocks arginine vasopressin receptor 2 in the renal collecting duct. Its diuretic mechanism involves selective water reabsorption by affecting the water reabsorption receptor aquaporin 2. Given that liver cirrhosis patients exhibit hyponatremia due to...

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Autores principales: Adachi, Takuya, Takeuchi, Yasuto, Takaki, Akinobu, Oyama, Atsushi, Wada, Nozomu, Onishi, Hideki, Shiraha, Hidenori, Okada, Hiroyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8197450/
https://www.ncbi.nlm.nih.gov/pubmed/34070416
http://dx.doi.org/10.3390/ijms22115582
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author Adachi, Takuya
Takeuchi, Yasuto
Takaki, Akinobu
Oyama, Atsushi
Wada, Nozomu
Onishi, Hideki
Shiraha, Hidenori
Okada, Hiroyuki
author_facet Adachi, Takuya
Takeuchi, Yasuto
Takaki, Akinobu
Oyama, Atsushi
Wada, Nozomu
Onishi, Hideki
Shiraha, Hidenori
Okada, Hiroyuki
author_sort Adachi, Takuya
collection PubMed
description Tolvaptan is a recently available diuretic that blocks arginine vasopressin receptor 2 in the renal collecting duct. Its diuretic mechanism involves selective water reabsorption by affecting the water reabsorption receptor aquaporin 2. Given that liver cirrhosis patients exhibit hyponatremia due to their pseudo-aldosteronism and usage of natriuretic agents, a sodium maintaining agent, such as tolvaptan, is physiologically preferable. However, large scale studies indicating the patients for whom this would be effective and describing management under its use have been insufficient. The appropriate management of cirrhosis patients treated with tolvaptan should be investigated. In the present review, we collected articles investigating the effectiveness of tolvaptan and factors associated with survival and summarized their management reports. Earlier administration of tolvaptan before increasing the doses of natriuretic agents is recommended because this may preserve effective arterial blood volume.
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spelling pubmed-81974502021-06-13 Management of Cirrhotic Ascites under the Add-on Administration of Tolvaptan Adachi, Takuya Takeuchi, Yasuto Takaki, Akinobu Oyama, Atsushi Wada, Nozomu Onishi, Hideki Shiraha, Hidenori Okada, Hiroyuki Int J Mol Sci Review Tolvaptan is a recently available diuretic that blocks arginine vasopressin receptor 2 in the renal collecting duct. Its diuretic mechanism involves selective water reabsorption by affecting the water reabsorption receptor aquaporin 2. Given that liver cirrhosis patients exhibit hyponatremia due to their pseudo-aldosteronism and usage of natriuretic agents, a sodium maintaining agent, such as tolvaptan, is physiologically preferable. However, large scale studies indicating the patients for whom this would be effective and describing management under its use have been insufficient. The appropriate management of cirrhosis patients treated with tolvaptan should be investigated. In the present review, we collected articles investigating the effectiveness of tolvaptan and factors associated with survival and summarized their management reports. Earlier administration of tolvaptan before increasing the doses of natriuretic agents is recommended because this may preserve effective arterial blood volume. MDPI 2021-05-25 /pmc/articles/PMC8197450/ /pubmed/34070416 http://dx.doi.org/10.3390/ijms22115582 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Adachi, Takuya
Takeuchi, Yasuto
Takaki, Akinobu
Oyama, Atsushi
Wada, Nozomu
Onishi, Hideki
Shiraha, Hidenori
Okada, Hiroyuki
Management of Cirrhotic Ascites under the Add-on Administration of Tolvaptan
title Management of Cirrhotic Ascites under the Add-on Administration of Tolvaptan
title_full Management of Cirrhotic Ascites under the Add-on Administration of Tolvaptan
title_fullStr Management of Cirrhotic Ascites under the Add-on Administration of Tolvaptan
title_full_unstemmed Management of Cirrhotic Ascites under the Add-on Administration of Tolvaptan
title_short Management of Cirrhotic Ascites under the Add-on Administration of Tolvaptan
title_sort management of cirrhotic ascites under the add-on administration of tolvaptan
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8197450/
https://www.ncbi.nlm.nih.gov/pubmed/34070416
http://dx.doi.org/10.3390/ijms22115582
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