Table 2.
Outcomes of standard treatments (STD, N=14, including fluid restriction and/or hypertonic saline), tolvaptan (TLV, N=14), and fluid restriction only (excluding hypertonic saline, N=11) in the management of post-operative hyponatremia.
| STD (N=14) | TLV (N=14) | p-value (STD vs. TLV) | Fluid restriction (N=11) | p-value (Fluid restriction vs. TLV) | |
|---|---|---|---|---|---|
| Timing of administration, p.o. days | 6 (3 - 10) | 7 (6 - 9) | 0.24 | 7 (3 – 10) | 0.42 |
| Pre-treatment S-Na, mmol/L |
130 (125-134) | 125 (112-131) | 0.003 | 130 (128 - 134) | <0.001 |
| S-Na at 24-h, mmol/L |
129 (124-140) | 137 (129-151) | 0.02 | 129 (124 – 140) | 0.02 |
| 24-h correction rate, mmolL-1/24h | +1 (-5 to +8) | +12.5 (+5 to +26) | <0.001 | -1 (-5 to +8) | <0.001 |
| Adj. 24-h correction rate, mmolL-1/24h |
+1.8 | +12.0 | <0.001 | +0.8 | <0.001 |
| 24-h overcorrection (>10 mmolL-1/24h), N (%) |
0 (0) | 9 (64) | <0.001 | 0 (0) | 0.001 |
| S-Na normalized at 24-h, N (%) | 3 (21) | 7 (50) | 0.12 | 3 (27) | 0.24 |
| Hypernatremia at 24-h, N (%) |
0 (0) | 1 (7) | >0.99 | 0 (0) | >0.99 |
| S-Na at 48-h, mmol/L |
131 (122-140) | 138 (132-144) | 0.02 | 132 (122 – 140) | 0.06 |
| 48-h correction rate, mmolL-1/48h |
+4.5 (-8 to +9) | +15 (+7 to +20) | <0.001 | +2 (-8 to +9) | <0.001 |
| Adj. 48-h correction rate, mmolL-1/48h |
+4.5 | +13.4 | 0.004 | +3.9 | 0.01 |
| 48-h overcorrection (>18 mmolL-1/48h), N (%) |
0/8 (0) | 2/14 (14) | 0.52 | 0/6 (0) | >0.99 |
| S-Na normalized at 48-h, N (%) | 2/8 (25) | 12/14 (86) | 0.008 | 2/6 (33) | 0.04 |
| Hypernatremia at 48-h, N (%) |
0 (0) | 0 (0) | – | 0 (0) | – |
| Side effects, N (%) |
0 (0) | 0 (0) | – | 0 (0) | – |
| Osmotic demyelination, N (%) |
0 (0) | 0 (0) | – | 0 (0) | – |
p.o., post-operative. Adj., correction rates adjusted by pre-treatment sodium levels. S-Na, serum sodium. 24-h, 24 hours after initiation of treatment. 48-h, 48 hours after initiation of treatment.
Median (and range, in brackets) is reported for quantitative variable; absolute frequency (and percentage, in brackets) is reported for categorical variables. P-values equal to or below 0.05 are reported in bold characters. Follow-up at 48 hours from treatment initiation was available in 8 patients of the STD group, as 6 were switched to TLV.