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Tolvaptan treatment in hyponatremia due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH): effects on survival in patients with cancer

  • Nephrology - Original Paper
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Abstract

Purpose

To investigate the clinical outcomes of patients with hyponatremia who received supportive treatment or tolvaptan plus supportive treatment and the effects of treatment and other variables on overall survival

Methods

This study included oncology patients who were hospitalized at two oncology centers between January 1, 2016 and December 31, 2019 for hyponatremia (sodium levels < 135 mEq/L) and who received tolvaptan plus supportive treatment (n = 22) or supportive treatment only (n = 42).

Results

The median age of all the patients was 59 years (range 26–85) and 64.1% of the patients were male. There was no statistically significant difference between patients in the tolvaptan plus supportive treatment (TpST) group and the supportive treatment only (ST) group in terms of gender and age (p > 0.05). In the TpST group, recovery days of the hyponatremia after treatment and the length of hospital stay was shorter and hyponatremia symptoms and hospital complications were less frequent compared to the ST group (p < 0.05). There was no significant difference between the TpST group and the ST group in terms of overall survival (OS). OS was shorter in men who were non-responders to hyponatremia treatment and had recurrent hyponatremia. Multivariable analysis showed that normal sodium levels after treatment decreased the risk of death.

Conclusion

In the treatment of hyponatremia in cancer patients, TpST was found to have more positive effects on blood sodium levels, length of hospital stay, hospital complications, and hyponatremia symptoms compared to ST. A decreased risk of death was observed in patients with normal sodium levels after treatment.

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Data availability

Data are available at Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital and Gulhane Training and Research Hospital.

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Authors and Affiliations

  1. Department of Medical Oncology, University of Health Sciences, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey

    Irem Bilgetekin, Fatma Bugdayci Basal, Cengiz Karacin & Berna Oksuzoglu

  2. Department of Medical Oncology, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey

    Ismail Erturk & Nuri Karadurmus

  3. Department of Medical Oncology, Memorial Ankara Hospital, Uskudar University, Ankara, Turkey

    Umut Demirci

Authors
  1. Irem Bilgetekin
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  2. Ismail Erturk
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  3. Fatma Bugdayci Basal
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  4. Cengiz Karacin
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  5. Nuri Karadurmus
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  6. Berna Oksuzoglu
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  7. Umut Demirci
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Corresponding author

Correspondence to Cengiz Karacin.

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Conflict of interest

The authors declare that they have no confict of interest.

Ethical approval

Ethical approval was approved by the local ethical committee of the University of Health Sciences, Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital (TUEK meeting number: 85-31.12.2019) in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

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Bilgetekin, I., Erturk, I., Basal, F.B. et al. Tolvaptan treatment in hyponatremia due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH): effects on survival in patients with cancer. Int Urol Nephrol 53, 301–307 (2021). https://doi.org/10.1007/s11255-020-02623-7

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  • DOI: https://doi.org/10.1007/s11255-020-02623-7

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