Published online Mar 21, 2015. doi: 10.3748/wjg.v21.i11.3197
Peer-review started: October 21, 2014
First decision: November 14, 2014
Revised: December 2, 2014
Accepted: January 30, 2015
Article in press: January 30, 2015
Published online: March 21, 2015
Core tip: Hyponatremia is the most common electrolyte abnormality observed in hospitalized patients and is a common finding in patients with advanced cirrhosis. The management of hyponatremia in cirrhosis is challenging as conventional therapy for hyponatremia including fluid restriction and loop diuretics are frequently inefficacious. Vaptans, drugs that selectively antagonizes the effects of arginine vasopressin on the V2 receptors in the kidney tubules, represent a logical step in the treatment of hyponatremia. The currently available vaptans, however, are not approved for use in patients with cirrhosis due to the increased risk for hepatic failure and mortality.