Abstract | BACKGROUND/OBJECTIVES: METHODS: We conducted a systematic review of randomized controlled trials with searches of CENTRAL and MEDLINE to January 2014 and reference lists without language restriction. Meta-analysis using a random-effects model was done for all-cause and cardiovascular mortality, hospitalization for heart failure, changes in clinical assessment of HF, serum sodium concentration (Na), kidney function and treatment-specific side effects. RESULTS: We identified 13 trials and 5,525 participants. In 10 trials, participants received standard therapy for HF. In low-quality evidence, VRAs in patients with HF had no effect on all-cause mortality risk ratios (RR 0.98; CI 0.88-1.08), cardiovascular mortality (RR 1.03; CI 0.91-1.16) or change in creatinine mean difference (MD -0.01; CI -0.10 to 0.09 mg/dL), but reduced body weight by 0.8 kg from baseline (MD -0.83; CI -1.10 to -0.55 kg) and increased Na (MD 2.61; 95 % CI 1.88-3.35 mmol/L). Compared with placebo, VRAs increased the risk of adverse events by 14 % (RR 1.14; CI 1.04-1.26). Studies were generally limited to short-term follow-up with limited data available on patient important outcomes. CONCLUSIONS:
Vasopressin receptors antagonists may reduce body weight and increase Na but do not improve all-cause mortality, cardiovascular mortality or kidney function. In addition, acceptability of long-term treatment side effects and hospitalization appears problematic.
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Authors | Ionut Nistor, Iris Bararu, Maria-Cristina Apavaloaie, Luminita Voroneanu, Mihaela-Dora Donciu, Mehmet Kanbay, Evi V Nagler, Adrian Covic |
Journal | International urology and nephrology
(Int Urol Nephrol)
Vol. 47
Issue 2
Pg. 335-44
(Feb 2015)
ISSN: 1573-2584 [Electronic] Netherlands |
PMID | 25281314
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
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Chemical References |
- Antidiuretic Hormone Receptor Antagonists
- Sodium
- Creatinine
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Topics |
- Antidiuretic Hormone Receptor Antagonists
(adverse effects, therapeutic use)
- Body Weight
(drug effects)
- Cause of Death
- Creatinine
(blood)
- Heart Failure
(drug therapy, mortality)
- Humans
- Randomized Controlled Trials as Topic
- Sodium
(blood)
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