Kronik kalp yetersizliğinin kötüleşmesi nedeniyle hastaneye yatırılan ciddi hiponatremik hastalarda tolvaptan kullanımı: Türkiye’de tek merkezden ilk deneyim

Use of tolvaptan in patients hospitalized for worsening chronic heart failure with severe hyponatremia: The initial experience at a single-center in Turkey

Bülent ÖZDEMİR, Yüksel ÇAVUŞOĞLU, Aysel Aydın KADERLİ, Abdülmecit YILDIZ, Bülent Cuma GÜL, İbrahim BARAN, Ali AYDINLAR, Sümeyye GÜLLÜLÜ, Saim SAĞ

Abstract

Objective: The aim of the present study was to assess the efficacy and safety of tolvaptan for severe hyponatremia (SH) in hypervolemic heart failure (HF) patients within daily clinical practice.Methods: We restrospectively reviewed our database on tolvaptan as an add-on treatment in hypervolemic patients admitted to our clinic due to deterioration of HF and having hyponatremia resistant to standard therapy. Severe hyponatremia was defined as serum sodium concentration ≤125 mEq/L. The database included demographic, clinical, laboratory, and echocardiographic findings on admission, and numerous outcome measures for oral tolvaptan treatment were used to assess its efficacy and safety.Results: The study group consisted of 56 hypervolemic HF patients with severe hyponatremia (25 female and 31 male) with mean age of 66 years. All patients received a single dose of tolvaptan 15 mg daily for an average of 3.2 days due to severe hyponatremia. Sodium and potassium concentrations, fluid intake, and urine volume increased (p

Özet

Amaç: Hipervolemik kalp yetersizliği (KY) olan hastalardaki ciddi hiponatremide tolvaptan'ın etkinlik ve güvenilirliğini değerlendirmek.Yöntemler: KY'nin kötüleşmesi nedeniyle kliniğimize yatırılan hipervolemik hastalarda standart tedaviye dirençli hiponatreminin tolvaptan eklenerek tedavisi için oluşturulan bir veritabanı geriye dönük olarak tarandı. Serum sodyum düzeyinin