Petra Hrabčáková, Ivica Lazúrová
The treatment of euvolemic and hypervolemic hyponatremia is limited, not very well tolerated and mostly ineffective. Treatment options for the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) include fluid restriction, saline infusion, furosemide, demeclocycline, and urea. All of them have their limitations and there are no guidelines for their use. In recent years antagonists of vasopressin V1 and V2 receptors called vaptans were used in treatment of SIADH. Vaptans specifically prevent the reabsorption of water from the renal tubules, without affecting solute excretion. Several vasopressin receptor antagonists have been developed for clinical use the (conivaptan, lixivaptan, satavaptan, tolvaptan, mozvaptan). The most of them were successful in the treatment of hypervolemic hyponatremia. Clinical trials with vaptans used in patients with heart failure or cirrhosis showed good effect on morbidity, but not on the improvement of mortality. Because of that the use of vaptans in the treatment of hypervolemic hyponatremia is limited.