Abstract
Congestive heart failure (CHF) is present in approximately 2 to 3% of patients older than age 65 years and is 5 to 10% in patients beyond age 75 years. Hyponatremia is a marker of mortality in patients with CHF. Standard therapy includes loop diuretics, but this is sometimes limited by extensive salt losses and diuretic resistance. Vasopressin antagonists like tolvaptan (PO) and conivaptan (IV) are another option in these difficult to treat patients, but use is limited due to availability, price, and side effects that include liver failure, overcorrection, and increased thirst.
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