Vasopressin Antagonists in the Treatment of Water-Retaining Disorders

  • Sumit Kumar
    Department of Nephrology, Presbyterian Hospital, Dallas, TX.
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  • Tomas Berl
    Address reprint requests to Tomas Berl, MD, Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado at Denver and Health Sciences Center, 4200 E. Ninth Ave, Box C281, Denver, CO 80262.
    Department of Medicine, Division of Renal Diseases and Hypertension, University of Colorado at Denver and Health Sciences Center, Denver, CO.
    Search for articles by this author


      The tools available to physicians for the treatment of hyponatremia, the most common of electrolyte disorders, are limited by lack of effectiveness, compliance difficulties, and toxicity problems. For this reason the development of novel oral antagonists of vasopressin provide a new approach to the management of these disorders. Since vasopressin plays a central role in the pathogenesis of most hyponatremic disorders, the inhibition of binding of the hormone to its receptors is likely to provide a most reliable and reproducible response leading to increases in free water excretion. This article reviews many of the studies that have been undertaken with this new class of agents, both in hypovolemic and hypervolemic settings.


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