Risk Factors for Developing Hyponatremia During Terlipressin Treatment: A Retrospective Analyses in Variceal Bleeding. Issue 7 (August 2015)

• Record Type: Journal Article
• Authors: Yim, Sun Young; Seo, Yeon Seok; Jung, Chang Ho; Kim, Tae Hyung; Kim, Eun Sun; Keum, Bora; Kim, Ji Hoon; An, Hyonggin; Yim, Hyung Joon; Yeon, Jong Eun; Jeen, Yoon Tae; Lee, Hong Sik; Chun, Hoon Jai; Byun, Kwan Soo; Um, Soon Ho; Kim, Chang Duck; Ryu, Ho Sang
• Is Part Of: Journal of clinical gastroenterology. Volume 49:Issue 7(2015)
• Publication Date: 2015-08
• Subjects: body mass index -- hyponatremia -- variceal bleeding -- terlipressin; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Digestive organs -- Diseases; Gastroenterology; Periodicals; Periodicals; 616.33005
• DOI: 10.1097/MCG.0000000000000217
• Languages: English
• ISSNs: 0192-0790

Abstract

Abstract : Goals: The aim of this study was to evaluate the risk factors and clinical significance of terlipressin-induced hyponatremia. Background: Patients receiving terlipressin treatment frequently develop hyponatremia. However, its clinical significance and risk factors are not fully elucidated. Study: Records of patients treated with terlipressin for variceal bleeding were analyzed. Hyponatremia was defined as a decrease in serum sodium (Na) level of >5 mEq/L from the baseline level; severe hyponatremia as a decrease in serum Na level of >10 mEq/L from the baseline level; and rapid severe hyponatremia as a decrease in serum Na level of >10 mEq/L within 3 days of treatment. Results: The study involved 151 patients (mean age, 55.1±11.8 y) with male predominance (80.8%). Baseline serum Na and creatinine levels were 137.2±6.1 mEq/L and 0.9±0.4 mg/dL, respectively. Patients were treated with terlipressin for 4.5±1.9 days. Changes in serum Na levels from baseline were 0.4±4.1, −1.1±4.8, −4.0±7.0, −6.5±9.1, and −6.1±11.2 mEq/L, whereas the frequencies of hyponatremia and severe hyponatremia were 13.6%, 30.4%, 50.8%, 63.5%, and 66.9% and 0%, 8.8%, 23.3%, 33.0%, and 38.8% on days 1, 2, 3, 4, and 5 of treatment, respectively. Younger age, lower Child-Pugh score, higher serum Na level, and longer duration of terlipressin treatment were independent risk factors. Rapid severe hyponatremia developed in 29 patients (19.2%); lower body mass index was an additional risk factor in this group. Mortality was not associated with hyponatremia. Conclusions: Terlipressin-induced hyponatremia occurred frequently, especially in young patients with good liver function and higher Na level. Caution is required when administering terlipressin to patients with low body mass index. Abstract : Supplemental Digital Content is available in the text.