Case Report
Management Challenges in a Child with Chronic Hyponatremia: Use of V2 Receptor Antagonist
Table 2
Clinical course with initiation of tolvaptan therapy.
| Timeline | Weight (Kg) | Sodium (mEq/L) | Tolvaptan dose | Serum osmolality (mOsm/Kg) | Urine osmolality (mOsm/Kg) | AVP (pg/mL) |
| Prior to initiation of tolvaptan therapy | 24.7 | 121 | None | 263 | 428 | 11.1 | Day 2 of initiation of therapy | 24.8 | 127 | 7.5 mg | | 26 | 43.4 | 6 months after initiation | 25.6 | 123 | Increased to 15 mg | 250 | 55 | 3.0 | 7 months after initiation | 25.9 | 123 | Increased to 22.5 mg | | | | 17 months after initiation | 26 | 119 | Increased to 30 mg | 253 | | 19.5 | 24 months after initiation | 28.6 | 124 | Tolvaptan gradually stopped | | | | 1 year after stopping tolvaptan therapy | 31.4 | 118-119 | None | 235 | 242 | 2.2 |
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