This systematic review of clinical trials of the use of vaptans (tolvaptan, satavaptan, and lixivaptan) in patients with cirrhosis and hyponatremia found no difference in mortality, variceal bleeding, hepatic encephalopathy, SBP, hepatorenal syndrome, or renal failure, compared to placebo. The use of vaptans did increase serum sodium and reduced weight, but also increased the risk of adverse events. The weight of evidence does not support the use of vaptans in cirrhotics with hyponatremia (abstract).
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