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Objectives: The recommended dose of tolvaptan for hyponatraemia secondary to SIADH is 15mg. We evaluated the efficacy of an initial 7.5mg dose and determined the frequency where sodium (Na+) correction exceeded safe limits, defined as an increment of ≥10 mmol/L, within the initial 8 or 24 hours of administration.

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Comparative study of the effectiveness of tolvaptan versus urea in patients with hyponatremia caused by SIADH.

Rev Clin Esp (Barc)

December 2024

Unidad de Medicina Oral, Cirugía Oral e Implantología, Facultad de Medicina y Odontología, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.

Background And Objectives: Hyponatraemia is common in elderly and hospitalised patients, often caused by the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This study evaluates the efficacy and safety of tolvaptan and urea in patients with hyponatraemia and SIADH.

Materials And Methods: An observational cohort study was conducted on 198 patients with SIADH and hyponatraemia (Na+ <135 mmol/L) at the Complejo Hospitalario Universitario de Pontevedra from January 2015 to May 2022.

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Article Synopsis
  • Secondary adrenal insufficiency (SAI) is a rare condition caused by a deficiency in the adrenocorticotropic hormone (ACTH) from the pituitary gland, leading to symptoms like chronic low sodium levels (hyponatremia), and can present a diagnostic challenge, particularly when there are no identifiable triggers.
  • An 80-year-old woman with a history of multiple health issues was diagnosed with isolated adrenal insufficiency after presenting with weakness and fatigue, leading to complications that required specific treatments including corticosteroids.
  • This case highlights the importance of recognizing atypical presentations of adrenal insufficiency, as well as the effectiveness of corticosteroid replacement therapy in resolving symptoms and normalizing sodium levels.
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Introduction: Long hospital stay is associated with high costs and poor quality of life in elderly patients with heart failure (HF). This study aimed to investigate the association of early administration of tolvaptan with length of hospital stay among elderly patients with HF.

Methods: The cohort included elderly patients (age ≥ 75 years) admitted to Shinonoi General Hospital between July 2016 and December 2018 with a primary diagnosis of acute decompensated HF treated with tolvaptan.

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[Genetics in nephrology - any news?].

Dtsch Med Wochenschr

November 2024

Klinik II für Innere Medizin - Nephrologie, Rheumatologie, Diabetologie und Allgemeine Innere Medizin, Uniklinik Köln, Köln, Deutschland.

While genetic kidney diseases were long regarded as a rare cause of kidney failure, it has been shown in recent years that they account for a relevant proportion of cases. In cohorts of kidney transplant recipients, a monogenic cause is found in up to 30% of cases. Identifying the genetic cause of kidney disease has become much easier thanks to technological advances in DNA sequencing.

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