Hyponatraemia and cirrhosis  

作　　者：Robert J.Gianotti Andres Cardenas 

机构地区：[1]Department of Gastroenterology,Beth Israel Deaconess Medical Center,Boston MA [2]GI Unit,Institut Clinic de Malalties Digestives i Metaboliques,Hospital Clinic,University of Barcelona

出　　处：《Gastroenterology Report》2014年第1期21-26,共6页胃肠病学报道（英文）

摘　　要：Hyponatraemia is a common complication of advanced cirrhosis related to an impairment in the renal capacity for eliminating solute-free water,causing a retention of water that is disproportionate to the retention of sodium,thus leading to a reduction in serum sodium concentration and hypo-osmolality.The main pathogenic factor responsible for hyponatraemia is a non-osmotic hypersecretion of arginine vasopressin(AVP)or antidiuretic hormone from the neurohypophysis,related to circulatory dysfunction.Hyponatraemia in cirrhosis is associated with increased morbidity and mortality.Hyponatraemia is also associated with increased morbidity and impaired short-term survival after transplantation.The current standard of care based on restricting fluids to 1-1.5 L/day is rarely effective.Other approaches,such as albumin infusion and the use of vaptans—which act by specifically antagonizing the effects of AVP on the V2 receptors located in the kidney tubules—have been evaluated for their role in the management of hyponatraemia.The short-term treatment with vaptans is associated with a marked increase in renal solute-free water excretion and improvement of hyponatraemia;however their use in patients with end-stage liver disease is limited by hepatotoxic effects of some of these drugs.Longterm administration of vaptans seems to be effective in maintaining the improvement of serum sodium concentration,but the available information is still limited.

关 键 词：HYPONATRAEMIA CIRRHOSIS end-stage liver disease VAPTANS 

分 类 号：R57[医药卫生—消化系统]