Hyponatremia in heart failure: The role of arginine vasopressin and diuretics
Rosner MH et al. – Vasopressin-receptor antagonists may prove useful for treatment of heart failure (HF), pending further study of the exact role of these agents. Methods- Overview of the role of arginine vasopressin (AVP) in development of hyponatremia in HF pts, the role of diuretics, and the potential for vasopressin-receptor antagonists in treatment of HF
- MEDLINE literature search for articles relating to HF, diuretics, hyponatremia, AVP, and vasopressin-receptor antagonists
Results- HF affects >5 million US pts and is associated with substantial cost, morbidity, and mortality
- Hyponatremia: complication associated with HF and its treatment
- Poor outcomes associated with hyponatremia in HF pts can limit use of diuretic therapy
- AVP is primary stimulus to hyponatremia development in these pts
- Drugs that antagonize the vasopressin V2 receptor primarily responsible for kidney water resorption studied in this setting
- These drugs associated with improvements in serum sodium concentration, urine output, and body weight; no long-term mortality benefit in HF pts
- In pt subset with baseline hyponatremia, these drugs improved quality of life scores
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