Effectiveness of Urea and Tolvaptan in the Treatment of Hypotonic Hyponatremia

This article belongs to the Section Cardiovascular Medicine.

Detalhes bibliográficos
Autores: Delgado-Cuesta, Juan, Escorial-Moya, C., Vallejo-Vaz, Antonio J., Santos-Ramos, Bernardo, Varela, Jose M., Calderón, Enrique J., Medrano, Francisco Javier
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Recursos:Consejo Superior de Investigaciones Científicas (CSIC)
Repositorio:DIGITAL.CSIC. Repositorio Institucional del CSIC
OAI Identifier:oai:digital.csic.es:10261/400247
Acesso em linha:http://hdl.handle.net/10261/400247
https://api.elsevier.com/content/abstract/scopus_id/105006766808
Access Level:acceso abierto
Palavra-chave:Heart failure
Hypotonic hyponatremia
Syndrome of inappropriate antidiuresis
Tolvaptan
Urea
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spelling Effectiveness of Urea and Tolvaptan in the Treatment of Hypotonic HyponatremiaDelgado-Cuesta, JuanEscorial-Moya, C.Vallejo-Vaz, Antonio J.Santos-Ramos, BernardoVarela, Jose M.Calderón, Enrique J.Medrano, Francisco JavierHeart failureHypotonic hyponatremiaSyndrome of inappropriate antidiuresisTolvaptanUreaThis article belongs to the Section Cardiovascular Medicine.[Objective] The objective of this study was to compare the effectiveness of urea and tolvaptan in the treatment of plasma sodium levels in patients with hypotonic hyponatremia.[Methods] This was an observational, longitudinal, and retrospective study including all adult patients who received treatment with urea or tolvaptan for hypotonic hyponatremia from 1 April 2014 to 31 October 2023 at the Department of Internal Medicine, Virgen del Rocío University Hospital, Seville, Spain.[Results] Forty-seven (55.3%) patients received urea and 38 (44.7%) tolvaptan. The drugs were prescribed for the treatment of syndrome of inappropriate antidiuresis (SIAD) in 59 (69.4%) patients. The mean blood sodium level at the start of treatment was 123.5 ± 6.2 mEq/L. Overall, 61.7% and 63.2% of patients treated with urea and tolvaptan, respectively, achieved a normal blood sodium level (p = 0.89), although the time to have their sodium levels corrected differed between both groups: 41.7 ± 76 days with urea and 21 ± 23.9 days with tolvaptan (p = 0.038). The following were significant in the multivariate study: Initial sodium value (p = 0.037), absolute sodium improvement (p = 0.041), and percentage sodium improvement (p = 0.033). Among patients with SIAD, 69.5% achieved a normal sodium level; this figure was 45.5% for patients with heart failure. Three patients reported side adverse events in the urea group and none in the tolvaptan group.[Conclusions] Our data, reflecting real-world practice and follow-up of patients with hypotonic hyponatremia, suggest that both urea and tolvaptan are safe, well-tolerated, and have a similar effectiveness in correcting blood sodium levels in patients with hypotonic hyponatremia, overall and secondary to SIAD, though treatment with tolvaptan achieved this goal earlier than urea.This research received no external funding.Peer reviewedMultidisciplinary Digital Publishing InstituteDelgado-Cuesta, Juan [0000-0002-5947-6287]Escorial-Moya, C. [0009-0002-5236-2532]Vallejo-Vaz, Antonio J. [0000-0001-7954-1253]Santos-Ramos, Bernardo [0000-0003-4315-351X]Calderón, Enrique J. [0000-0002-3166-5086]Medrano, Francisco Javier [0000-0001-5863-344X]Consejo Superior de Investigaciones Científicas [https://ror.org/02gfc7t72]202520252025info:eu-repo/semantics/articlehttp://purl.org/coar/resource_type/c_6501Publisher's versioninfo:eu-repo/semantics/publishedVersionapplication/pdfhttp://hdl.handle.net/10261/400247https://api.elsevier.com/content/abstract/scopus_id/105006766808reponame:DIGITAL.CSIC. Repositorio Institucional del CSICinstname:Consejo Superior de Investigaciones Científicas (CSIC)InglésThe underlying dataset has been published as supplementary material of the article in the publisher platform at DOI https://doi.org/10.3390/jcm14103315https://doi.org/10.3390/jcm14103315Síinfo:eu-repo/semantics/openAccessoai:digital.csic.es:10261/4002472026-05-22T06:33:51Z
dc.title.none.fl_str_mv Effectiveness of Urea and Tolvaptan in the Treatment of Hypotonic Hyponatremia
title Effectiveness of Urea and Tolvaptan in the Treatment of Hypotonic Hyponatremia
spellingShingle Effectiveness of Urea and Tolvaptan in the Treatment of Hypotonic Hyponatremia
Delgado-Cuesta, Juan
Heart failure
Hypotonic hyponatremia
Syndrome of inappropriate antidiuresis
Tolvaptan
Urea
title_short Effectiveness of Urea and Tolvaptan in the Treatment of Hypotonic Hyponatremia
title_full Effectiveness of Urea and Tolvaptan in the Treatment of Hypotonic Hyponatremia
title_fullStr Effectiveness of Urea and Tolvaptan in the Treatment of Hypotonic Hyponatremia
title_full_unstemmed Effectiveness of Urea and Tolvaptan in the Treatment of Hypotonic Hyponatremia
title_sort Effectiveness of Urea and Tolvaptan in the Treatment of Hypotonic Hyponatremia
dc.creator.none.fl_str_mv Delgado-Cuesta, Juan
Escorial-Moya, C.
Vallejo-Vaz, Antonio J.
Santos-Ramos, Bernardo
Varela, Jose M.
Calderón, Enrique J.
Medrano, Francisco Javier
author Delgado-Cuesta, Juan
author_facet Delgado-Cuesta, Juan
Escorial-Moya, C.
Vallejo-Vaz, Antonio J.
Santos-Ramos, Bernardo
Varela, Jose M.
Calderón, Enrique J.
Medrano, Francisco Javier
author_role author
author2 Escorial-Moya, C.
Vallejo-Vaz, Antonio J.
Santos-Ramos, Bernardo
Varela, Jose M.
Calderón, Enrique J.
Medrano, Francisco Javier
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv Delgado-Cuesta, Juan [0000-0002-5947-6287]
Escorial-Moya, C. [0009-0002-5236-2532]
Vallejo-Vaz, Antonio J. [0000-0001-7954-1253]
Santos-Ramos, Bernardo [0000-0003-4315-351X]
Calderón, Enrique J. [0000-0002-3166-5086]
Medrano, Francisco Javier [0000-0001-5863-344X]
Consejo Superior de Investigaciones Científicas [https://ror.org/02gfc7t72]
dc.subject.none.fl_str_mv Heart failure
Hypotonic hyponatremia
Syndrome of inappropriate antidiuresis
Tolvaptan
Urea
topic Heart failure
Hypotonic hyponatremia
Syndrome of inappropriate antidiuresis
Tolvaptan
Urea
description This article belongs to the Section Cardiovascular Medicine.
publishDate 2025
dc.date.none.fl_str_mv 2025
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
http://purl.org/coar/resource_type/c_6501
Publisher's version
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10261/400247
https://api.elsevier.com/content/abstract/scopus_id/105006766808
url http://hdl.handle.net/10261/400247
https://api.elsevier.com/content/abstract/scopus_id/105006766808
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv The underlying dataset has been published as supplementary material of the article in the publisher platform at DOI https://doi.org/10.3390/jcm14103315
https://doi.org/10.3390/jcm14103315
Sí
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Multidisciplinary Digital Publishing Institute
publisher.none.fl_str_mv Multidisciplinary Digital Publishing Institute
dc.source.none.fl_str_mv reponame:DIGITAL.CSIC. Repositorio Institucional del CSIC
instname:Consejo Superior de Investigaciones Científicas (CSIC)
instname_str Consejo Superior de Investigaciones Científicas (CSIC)
reponame_str DIGITAL.CSIC. Repositorio Institucional del CSIC
collection DIGITAL.CSIC. Repositorio Institucional del CSIC
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812455

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