A Review of Dilutional Hyponatremia and Liver Transplantation
DOI:
https://doi.org/10.22516/25007440.24Keywords:
Hyponatremia, cirrhosis, liver transplantation, prognosisAbstract
Patients with advanced liver disease may present volume overloads that can lead to the development of dilutional hyponatremia primarily as the result of persistently high levels of antidiuretic hormone. Liver transplantation is the therapy of choice for patients with terminal liver disease. Patient survival time following transplantation is excellent. Dilutional hyponatremia has proven to be a prognostic factor for patients with cirrhosis, and it can even lead to mortality in patients on the waiting list for liver transplantation. Consequently, it is currently part of the scoring system for classifying patients with advanced liver disease who are on the waiting list for liver transplantation. The role of pretransplant hyponatremia in the prognoses of patients scheduled for liver transplantation is the subject of renewed interest, but the data in the literature is rather contradictory. Until recently, the only treatment for dilutional hyponatremia was the restriction of water intake, but now new
and encouraging treatments are available that are directed against dilutional hyponatremia in patients with cirrhosis. Nevertheless, little is known about their effects in patients with cirrhosis who are about to undergo liver transplantation.
Downloads
Languages:
enReferences
Guevara M, Gines P. Hyponatremia in liver cirrhosis: patho- genesis and treatment. Endocrinol Nutr 2010;57(Suppl 2):15-21.
Cardenas A, Gines P. Dilutional hyponatremia, hepatorenal syndrome and liver transplantation. Gastroenterol Hepatol 2008;31:29-36.
Angeli P, Wong F, Watson H, Gines P. Hyponatremia in cirrhosis: results of a patient population survey. Hepatology 2006;44:1535-42.
Planas R, Montoliu S, Balleste B, et al. Natural history of patients hospitalized for management of cirrhotic ascites. Clin Gastroenterol Hepatol 2006;4:1385-94.
Schrier RW, Arroyo V, Bernardi M, Epstein M, Henriksen JH, Rodes J. Peripheral arterial vasodilation hypothesis: a proposal for the initiation of renal sodium and water reten- tion in cirrhosis. Hepatology 1988;8:1151-7.
Epstein M. Deranged sodium homeostasis in cirrhosis. Gastroenterology 1979;76:622-35.
Arroyo V, Claria J, Salo J, Jimenez W. Antidiuretic hormone and the pathogenesis of water retention in cirrhosis with ascites. Semin Liver Dis 1994;14:44-58.
Schrier RW. Water and sodium retention in edematous disorders: role of vasopressin and aldosterone. Am J Med 2006;119:S47-53.
Bichet DG, Van Putten VJ, Schrier RW. Potential role of increased sympathetic activity in impaired sodium and water excretion in cirrhosis. N Engl J Med 1982;307:1552-7.
GinesP,BerlT,BernardiM,etal.Hyponatremiaincirrhosis: from pathogenesis to treatment. Hepatology 1998;28:851- 64.
Haussinger D, Kircheis G, Fischer R, Schliess F, vom Dahl S. Hepatic encephalopathy in chronic liver disease: a clinical manifestation of astrocyte swelling and low-grade cerebral edema? J Hepatol 2000;32:1035-8.
Santos O, Marín J, Muñoz O, et al. Trasplante hepático en adultos: Estado del arte. Rev Col Gastroenterol 2012;27: 21-31.
Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, ter Borg PC. A
model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology 2000;31:864-71.
Kim WR, Biggins SW, Kremers WK, et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med 2008;359:1018-26.
Moini M, Hoseini-Asl MK, Taghavi SA, et al. Hyponatremia a valuable predictor of early mortality in patients with cirrhosis listed for liver transplantation. Clin Transplant 2011;25:638-45.
Pugliese R, Fonseca EA, Porta G, et al. Ascites and serum sodium are markers of increased waiting list mortality in children with chronic liver failure. Hepatology 2013.
Londoño MC, Cárdenas A, Guevara M, et al. MELD score and serum sodium in the prediction of survival of patients with cirrhosis awaiting liver transplantation. Gut 2007;56:1283-90.
Ruf AE, Kremers WK, Chavez LL, Descalzi VI, Podesta LG, Villamil FG. Addition of serum sodium into the MELD score predicts waiting list mortality better than MELD alone. Liver Transpl 2005;11:336-43.
Biggins SW, Rodriguez HJ, Bacchetti P, Bass NM, Roberts JP,TerraultNA.Serumsodiumpredictsmortalityinpatients listed for liver transplantation. Hepatology 2005;41:32-9.
Londoño MC, Guevara M, Rimola A, et al. Hyponatremia impairs early posttransplantation outcome in patients with cirrhosis undergoing liver transplantation. Gastroenterology 2006;130:1135-43.
Karapanagiotou A, Kydona C, Papadopoulos S, et al. The effect of hyponatremia on the outcome of patients after orthotopic liver transplantation. Transplant Proc 2012;44:2724-6.
Boin IF, Capel C, Jr., Ataide EC, Cardoso AR, Caruy CA, Stucchi RS. Pretransplant hyponatremia could be associated with a poor prognosis after liver transplantation. Transplant Proc 2010;42:4119-22.
Li C, Wen TF, Mi K, Wang C, Yan LN, Li B. Analysis of infec- tions in the first 3-month after living donor liver transplanta- tion. World J Gastroenterol 2012;18:1975-80.
Fukuhara T, Ikegami T, Morita K, et al. Impact of preopera- tive serum sodium concentration in living donor liver trans- plantation. J Gastroenterol Hepatol. 2010;25: 978-984.
Abdalla S, Alves RCP, Fonseca EA, Vicenzi R, Gonçalves JE, Waisberg J. A hiponatremia como fator preditivo da perda precoce do transplante hepático na modalidade intervivos. Arq Bras Ciênc Saúde 2012;37:76-80.
Leise MD, Yun BC, Larson JJ, et al. The effect of pretrans- plant serum sodium concentration on outcome following liver transplantation. Liver Transpl 2014.
Lee J, Kim DK, Lee JW, et al. Rapid correction rate of hypo- natremia as an independent risk factor for neurological com- plication following liver transplantation. Tohoku J Exp Med 2013;229:97-105.
Gaglio P, Marfo K, Chiodo J, 3rd. Hyponatremia in cirr- hosis and end-stage liver disease: treatment with the vaso- pressin V(2)-receptor antagonist tolvaptan. Dig Dis Sci 2012;57:2774-85.
Ishikawa T. Novel additional indication of tolvaptan: Can tolvaptan provide a beneficial therapeutic option in cirrho- tic patients with ascites? Hepatol Res 2014;44:70-2.
Gerbes AL, Gulberg V, Gines P, et al. Therapy of hyponatre- mia in cirrhosis with a vasopressin receptor antagonist: a ran- domized double-blind multicenter trial. Gastroenterology 2003;124: 933-9.
Guyader D, Patat A, Ellis-Grosse EJ, Orczyk GP. Pharmacodynamic effects of a nonpeptide antidiuretic hormone V2 antagonist in cirrhotic patients with ascites. Hepatology 2002;36:1197-205.
O›Leary JG, Davis GL. Conivaptan increases serum sodium in hyponatremic patients with end-stage liver disease. Liver Transpl 2009;15:1325-9.
Gines P, Wong F, Watson H, Milutinovic S, del Arbol LR, Olteanu D. Effects of satavaptan, a selective vasopressin V(2) receptor antagonist, on ascites and serum sodium in cirr- hosis with hyponatremia: a randomized trial. Hepatology 2008;48:204-13.
Cárdenas A, Gines P, Marotta P, et al. Tolvaptan, an oral vasopressin antagonist, in the treatment of hyponatremia in cirrhosis. J Hepatol 2012;56:571-8.
Lehrich RW, Ortiz-Melo DI, Patel MB, Greenberg A. Role of vaptans in the management of hyponatremia. Am J Kidney Dis 2013;62:364-76.
Krag A, Moller S, Pedersen EB, Henriksen JH, Holstein- Rathlou NH, Bendtsen F. Impaired free water excre- tion in child C cirrhosis and ascites: relations to distal tubular function and the vasopressin system. Liver Int 2010;30:1364-70.
Wong F, Gines P, Watson H, et al. Effects of a selective vaso- pressin V2 receptor antagonist, satavaptan, on ascites recu- rrence after paracentesis in patients with cirrhosis. J Hepatol 2010;53: 283-90.
Boyer TD. Tolvaptan and hyponatremia in a patient with cirrhosis. Hepatology 2010;51:699-702.
Schrier RW, Gross P, Gheorghiade M, et al. Tolvaptan, a selective oral vasopressin V2-receptor antagonist, for hypo- natremia. N Engl J Med 2006;355:2099-112.
Sakaida I, Kawazoe S, Kajimura K, et al. Tolvaptan for improvement of hepatic edema: A phase 3, multicenter, ran- domized, double-blind, placebo-controlled trial. Hepatol Res 2014;44:73-82.
Downloads
Published
How to Cite
Issue
Section
License
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
Los autores/as ceden sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación en esta revista.
Los contenidos están protegidos bajo una licencia de Creative Commons Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional.
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
