Treatment of Cirrhosis-Associated Hyponatremia Refractory to Vasopressin 2-Receptor Antagonist
Bibliographic record
Abstract
Hyponatremia in patients with cirrhosis is due to impaired water excretion from persistent release of antidiuretic hormone induced by diminished effective circulatory volume (ECV). The treatment of cirrhosis-associated hyponatremia is free water restriction and vasopressin-2-receptor antagonists (V2RAs). We report a cirrhotic patient with hyponatremia who failed to improve with V2RAs but corrected with treatment of hepatorenal syndrome (HRS). The failure of hyponatremia to improve with V2RAs was likely due to avid renal proximal Na + and H 2 O reabsorption from decreased ECV, resulting in diminished fluid delivery to the collecting tubule. Midodrine and octreotide improved the systemic hemodynamics and increased distal fluid delivery resulting in resolution of hyponatremia. To date, this is the first case report of a cirrhotic patient with hyponatremia refractory to V2RAs that resolved with treatment of HRS. J Med Cases. 2014;5(5):264-266 doi: http://dx.doi.org/ 10.14740 / jmc1745w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".