Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Cirrhosis I: Introduction01:23

Cirrhosis I: Introduction

28
Cirrhosis is a chronic, irreversible liver disease characterized by the widespread replacement of healthy liver tissue with fibrotic scar tissue and the formation of regenerative nodules.Etiology of cirrhosisCirrhosis results from sustained liver injury that triggers progressive fibrosis and structural remodeling. The underlying causes are diverse, encompassing common and less frequent clinical conditions. Regardless of the origin, all causes lead to chronic inflammation, hepatocyte loss, and...
28
Cirrhosis II: Pathophysiology01:24

Cirrhosis II: Pathophysiology

42
Cirrhosis is a progressive chronic liver injury caused by prolonged inflammation, excessive fibrotic remodeling, and impaired regeneration. Over time, repeated hepatic insults disrupt the liver’s architecture and function, leading to reduced blood flow, impaired bile drainage, and diminished metabolic capacity.Pathophysiology of cirrhosisCirrhosis arises from three main responses to chronic liver damage: inflammation, immune activation, and hepatocyte death. These processes lead to...
42
Hepatic Encephalopathy01:29

Hepatic Encephalopathy

53
DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic...
53
Nephrotic Syndrome I : Introduction01:24

Nephrotic Syndrome I : Introduction

1.2K
Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of...
1.2K
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

382
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
382
Ascites01:19

Ascites

47
DefinitionAscites is the buildup of fluid inside the peritoneal cavity. It occurs when fluid moves out of the vascular system faster than the peritoneal lymphatics can remove it. This fluid shift is most commonly seen in liver cirrhosis but can also appear in several other systemic disorders.EtiologyCirrhosis remains the leading cause of ascites. Other conditions that can contribute include:Heart failureConstrictive pericarditisAbdominal cancersNephrotic syndromeSevere protein–calorie...
47

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Associations of prenatal exposure to per- and polyfluoroalkyl substances (PFAS) and childhood vaccine-induced immunity.

Environmental health : a global access science source·2026
Same author

DNA methylation clocks and cognitive status among older adults in the US, NHANES 1999-2002.

Epigenetics reports·2026
Same author

Long-term molecular embedding of early life adversity: leukocyte DNA methylation and gene expression associations from childhood to young adulthood.

Epigenomics·2026
Same author

Joint Associations of Prenatal Per- and Polyfluoroalkyl Substances and Metal Mixtures with Adiposity in Childhood and Adolescence.

Environmental science & technology·2026
Same author

Identification of DNA methylation signatures of smoking in women and associations with cardiovascular disease mortality.

Communications biology·2026
Same author

Health insurance, healthcare access, and their roles in the association between blood lead levels and epigenetic aging in United States adults.

GeroScience·2026

Related Experiment Video

Updated: Apr 30, 2026

Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats
09:37

Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats

Published on: August 1, 2018

14.4K

Hyponatraemia and cirrhosis.

Robert J Gianotti1, Andres Cardenas

  • 1Department of Gastroenterology, Beth Israel Deaconess Medical Center, Boston MA and GI Unit, Institut Clinic de Malalties Digestives i Metaboliques, Hospital Clinic, University of Barcelona.

Gastroenterology Report
|April 25, 2014
PubMed
Summary

Hyponatraemia is a frequent issue in people with advanced cirrhosis. It happens when the kidneys can't remove enough water, leading to low sodium levels in the blood. The main cause is too much of a hormone called arginine vasopressin. This condition increases the risk of complications and death. Fluid restriction is the usual treatment, but it often doesn't work. Other options like albumin and vaptans have been tested. Vaptans help the kidneys get rid of more water, but some can harm the liver. Long-term use of vaptans shows promise, but more research is needed to confirm their safety and effectiveness.

Keywords:
cirrhosisend-stage liver diseasehyponatraemiavaptansHyponatraemia treatmentCirrhosis complicationsVaptan use in liver diseaseFluid restriction in cirrhosis

Frequently Asked Questions

More Related Videos

In vivo Liver Endocytosis Followed by Purification of Liver Cells by Liver Perfusion
12:35

In vivo Liver Endocytosis Followed by Purification of Liver Cells by Liver Perfusion

Published on: November 10, 2011

20.3K
Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis
04:36

Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis

Published on: October 2, 2020

2.3K

Related Experiment Videos

Last Updated: Apr 30, 2026

Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats
09:37

Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats

Published on: August 1, 2018

14.4K
In vivo Liver Endocytosis Followed by Purification of Liver Cells by Liver Perfusion
12:35

In vivo Liver Endocytosis Followed by Purification of Liver Cells by Liver Perfusion

Published on: November 10, 2011

20.3K
Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis
04:36

Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis

Published on: October 2, 2020

2.3K

Area of Science:

  • Hepatology and liver disease management
  • Electrolyte and fluid balance in critical care

Background:

Hyponatraemia frequently occurs in individuals with cirrhosis, especially in advanced stages. This condition is linked to the kidneys' reduced ability to excrete solute-free water. The imbalance leads to water retention that exceeds sodium retention, lowering serum sodium levels. The primary cause is non-osmotic hypersecretion of arginine vasopressin. This hormone is released due to circulatory dysfunction in cirrhosis. The condition is associated with higher risks of complications and death. It also worsens outcomes after liver transplantation. Standard fluid restriction strategies are often insufficient. Alternative treatments are being explored to address this issue.

Purpose Of The Study:

The study aims to evaluate the effectiveness of current and emerging treatments for hyponatraemia in cirrhosis. It focuses on why fluid restriction alone is not sufficient. The goal is to identify better therapeutic options for patients. The study considers the role of albumin infusion and vaptans. These drugs target vasopressin receptors in the kidneys. The purpose is to assess how these treatments affect water excretion and sodium levels. The study also examines the safety of vaptans in patients with severe liver disease. It highlights the need for long-term data on treatment efficacy.

Main Methods:

The research reviews existing literature on hyponatraemia in cirrhosis. It analyzes the mechanisms behind vasopressin overproduction. The study evaluates the impact of fluid restriction on serum sodium levels. It compares the outcomes of patients treated with albumin infusion. The study also investigates the use of vaptans in clinical trials. Researchers examine how these drugs influence water excretion. The focus is on short-term and long-term effects of vaptans. The study assesses the safety profile of these medications in liver disease.

Main Results:

Fluid restriction to 1-1.5 L/day is rarely effective in correcting hyponatraemia. Albumin infusion has shown some benefit in managing sodium levels. Vaptans increase solute-free water excretion and improve serum sodium concentration. Short-term use of vaptans is associated with significant improvements. However, some vaptans cause hepatotoxic effects in patients with cirrhosis. Long-term use of vaptans maintains improved sodium levels. The data on long-term outcomes remain limited. These findings suggest a need for further research on safer alternatives.

Conclusions:

Current fluid restriction strategies are insufficient for treating hyponatraemia in cirrhosis. Vaptans offer a promising alternative by targeting vasopressin receptors. Their short-term effectiveness is supported by clinical evidence. However, hepatotoxicity limits their use in end-stage liver disease. Long-term benefits of vaptans are still under investigation. The authors suggest that more research is needed to improve treatment options. They emphasize the importance of balancing efficacy and safety. They propose that future studies should focus on safer vaptan formulations.

The main cause is non-osmotic hypersecretion of arginine vasopressin due to circulatory dysfunction.

Vaptans antagonize vasopressin at V2 receptors in the kidney, increasing solute-free water excretion.

Fluid restriction is often insufficient because it does not address the underlying vasopressin overproduction.

Some vaptans can cause hepatotoxic effects, limiting their use in patients with end-stage liver disease.

Long-term use appears effective in maintaining improved sodium levels, but data are still limited.

The authors suggest further research on safer vaptan formulations and alternative therapies.