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Natremia and liver transplantation:The right amount of salt for a good recipe

World Journal of Hepatology 2020年第11期12卷 919-930页

作者： Ilaria Lenci Martina Milana Giuseppe Grassi Alessandro Signorello Andrea Aglitti Leonardo Baiocchi Department of Internal Medicine Hepatology UnitTor Vergata UniversityRome 00133Italy

An adequate balance between electrolytes and clear water is of paramount importance to maintaining physiologic *** imbalance and,in particular,hyponatremia is the most frequent electrolyte abnormality observed in hospitalized subjects,involving approximately one-fourth of *** changes occurring during liver cirrhosis predispose patients to an increased risk of sodium imbalance,and hypervolemic hyponatremia has been reported in nearly 50%of subjects with severe liver disease and *** vasodilatation,portal-systemic collaterals’opening and increased excretion of vasoactive modulators are all factors impairing clear water handling during liver *** concern,sodium imbalance has been consistently reported to be associated with increased risk of complications and reduced survival in liver disease *** the last decades clinical interest in sodium levels has been also extended in the field of liver *** that[Na+]in blood is an independent risk factor for in-list mortality led to the incorporation of sodium value in prognostic scores employed for transplant priority,such as model for end-stage liver disease-Na and *** the other hand,severe hyponatremic cirrhotic patients are frequently delisted by transplant centers due to the elevated risk of mortality after *** this review,we describe in detail the relationship between sodium imbalance and liver cirrhosis,focusing on its impact on peritransplant *** possible therapeutic approaches,in order to improve transplant outcome,are also discussed.

关键词： Sodium imbalance Liver transplant Cirrhosis vaptan Transplant list Hypervolemic hyponatremia

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Arginine vasopressin as a target in the treatment of acute heart failure

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World Journal of Cardiology 2014年第12期6卷 1252-1261页

作者： Nisha A Gilotra Stuart D Russell Division of Cardiology Department of Medicine Johns Hopkins Hospital Baltimore MD 21287 United States

Congestive heart failure(CHF) is one of the most common reasons for hospitalization in the United States. Despite multiple different beneficial medications for the treatment of chronic CHF, there are no therapies with a demonstrated mortality benefit in the treatment of acute decompensated heart failure. In fact, studies of inotropes used in this setting have demonstrated more harm than good. Arginine vasopressin has been shown to be up regulated in CHF. When bound to the V1 a and/or V2 receptors, vasopressin causes vasoconstriction, left ventricular remodeling and free water reabsorption. Recently, two drugs have been approved for use that antagonize these receptors. Studies thus far have indicated that these medications, while effective at aquaresis(free water removal), are safe and not associated with increased morbidity such as renal failure and arrhythmias. Both conivaptan and tolvaptan have been approved for the treatment of euvolemic and hypervolemic hyponatremia. We review the results of these studies in patients with heart failure.

关键词： Heart failure Arginine vasopressin antagonist vaptan Hyponatremia Aquaresis Vasopressin

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