Vasopressin antagonists--progress and promise.

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Abstract
Hyponatremia is the most common in-hospital electrolyte disorder that a physician encounters. Its management has been the subject of numerous studies and reviews. In patients with chronic heart failure or cirrhosis, water retention, mediated by the vasopressin V2 receptor in the renal collecting tubule, is an initially positive defense against a decrease in cardiac output or the dilated splanchnic circulation in cirrhosis.1 The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is, of course, another matter. Water retention in SIADH serves no physiologic purpose, and hyponatremia may be serious enough to require emergency measures.Until now, the management of hyponatremia . . .

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