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World J Hepatol. Nov 27, 2014; 6(11): 793-799
Published online Nov 27, 2014. doi: 10.4254/wjh.v6.i11.793
Published online Nov 27, 2014. doi: 10.4254/wjh.v6.i11.793
Role of vaptans in the management of hydroelectrolytic imbalance in liver cirrhosis
Antonio Facciorusso, Annabianca Amoruso, Viviana Neve, Matteo Antonino, Valentina Del Prete, Michele Barone, Department of Medical Sciences, Section of Gastroenterology University of Foggia, 71100 Foggia, Italy
Author contributions: Facciorusso A designed the study and wrote the article; Amoruso A, Neve V, Antonino M and Del Prete V performed the literature search; Barone M revised the manuscript.
Correspondence to: Michele Barone, Professor, Gastroenterology Section, Department of Medical Sciences, University of Foggia, AOU Ospedali Riuniti, Viale Pinto, 1, 71100 Foggia, Italy. michele.barone@unifg.it
Telephone: +39-8-8173848 Fax: +39-8-81733848
Received: June 9, 2014
Revised: September 9, 2014
Accepted: October 1, 2014
Published online: November 27, 2014
Revised: September 9, 2014
Accepted: October 1, 2014
Published online: November 27, 2014
Core Tip
Core tip: Increasing evidences support the central role of renal function alterations in the pathogenesis of hydroelectrolytic imbalances in cirrhotic patients. Since Arginin Vasopressin (AVP) plays an important role in the development of refractory ascites, dilutional hyponatremia and hepato-renal syndrome, selective antagonists of AVP receptors V2 (vaptans) have been recently introduced in the therapeutic algorithm of advanced cirrhotic patients. Despite the promising results of earlier phase-two studies, randomized controlled trials failed to find significant results in terms of efficacy. Moreover, concerns on their safety profile arise. More robust data from randomized controlled trials are needed.